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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG NO 22,5 <br />220 H~GH STREET NE <br /> SALEM OREGON 97301 <br /> <br /> PHONE:: 588-514,7 8:00 - 4::30 <br /> · , ~j 24 HOUR CODE-A-PHONE:: 588-7904 <br /> <br />I am performing work on a property I own or occupy <br />I am a regJsterOd builder OR r i the aUthOriZod representatire SIGNA/URE OF APPLICANT <br />Ota registered builder, <br />The work ¢,ill be performed by 8 rD( ~stered builder <br />Other <br /> <br />OWN~rE: 83/28/91 <br /> GREEN, JOE <br /> <br />liME: 15:17:02 <br /> <br /> 11695 LARK COURT NE <br />AURORA OR 97002 <br /> <br />USG OF BUILDING <br /> <br /> TAX LOT <br /> <br /> CONSTRLJC fJON TYPE <br /> <br />lvt&R.i ON COUNTY <br /> <br />NO <br /> <br />CATEGORY <br /> <br /> R~Si DEN1 IAL <br /> <br />R~.~IOENTIAL ACC~fsORY s"rRUC"fuRB:S SUaOlvl$1ON <br /> <br />CENTURY MEAO0~'~ ~4 <br /> <br /> Sire <br /> VALUA1 1 ON <br /> <br />26 19 <br /> NO · NO <br /> <br />12433 <br />$1,300.00 <br /> <br />IYPE: SUiLOiNG PE~IF OR APPLICATION NOs <br /> <br />OONfRA~IOR, NOt 71471 <br />TO~N & ~N'FRY EXCAVArlON <br /> <br /> 31162 <br />ARCHiTECt/ENGINEER, NO. <br /> <br />¥¢.)OBfgURN, OR 97071 <br /> 982-1702 mi-lONE: <br /> <br /> I'IEM <br />OUiLOING FEE <br />PL,~ REVIEW <br />BUILDING S'I'AFE <br />ZONIN¢SURICHARGE <br /> <br />TOTAL A88~ED FEES <br />PRE¥1OUS RECEIPTS <br />THiS RECEIPT <br /> <br />¢22.00 <br />14.30 <br /> <br />$38.50 <br /> <br />BALANCE [X]E $0.00 <br /> <br />PAYEE: <br />R~CEiVED BY; ~ TYPE: CHECK ~: 0 <br /> <br />· 1Rl5 i~ A VALID PERMIT * THiS PE~IT 8XPiRE~ 180 DAYS FR~ /TS ISSUE 0ALE. <br />CON$fRUCfION CEA~E~ FOR A PERIOD OF 180 OA~, OR IF ~F~CTI~ FAi~ [O ~EE'i' ALL <br />RE~IR~I'~ OF STA'f~ ~ ~0 ~Ri~ ~NTY BUILDING ~O Z~ING OROIN~C~, 1HIS PEril <br />~ALL BE~ME NULL ~ VOID. <br /> <br />OFFICE COPY <br /> <br /> <br />