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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG NO 225 <br />220 HiGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br />PhONe;; 588-5147 8:00 - 430 <br />HOUR CODE-A-PHONE: 5@8-7904 <br /> <br />SIGNATURE OF APPLICANT <br /> DATE <br /> <br />TAX LOT <br /> <br />CONSTRUC¥1ON TYPE <br /> <br /> 9963 MILL CREEK RO <br /> AUf45VILLE <br />USE OF BUILDING <br /> <br />OR 97325 <br /> <br />MARi GN ~XJLmN I Y <br /> <br />MAILING ADDRESS R~IDEN'f IAL ACCE~SSORY SfRUCFURES SUBDIVISION <br /> <br />NO <br /> <br />CATEGORY <br /> <br /> RESI DEN] I~L <br />OSCUPANSY <br /> <br />OCCUPAN f LC~] <br /> <br />N0 OF BEDROOM5 <br /> <br /> PHONE: V49-2802 <br />LOT R~ OCK <br /> <br /> SEC liON <br /> <br />544 <br /> <br />TOWNSHIP <br /> <br />SiTE NUMBER: <br /> VALUAIiON: <br />RANGE <br /> <br />UNITS ~S IRREG LOT lW <br /> SF NO <br /> <br />12344 <br /> $300.00 <br /> <br />:CORNER EFU <br />; NO. <br /> <br />48 <br /> <br />IYPB: 8UiLDING PERNiI OR APPLiCAfION NO: <br /> <br />OONrRAcfoR, NO. <br />PALANtUK, Iv'd~.Rf~ARE, T <br /> <br /> 50461 <br />ARCHI~EC'F/ENGiNEER, NO. <br /> <br />PHONE: 749-2802 PHONE <br /> <br />BUiLDiNG FEE <br />PLAN REVIEW <br />BUILOiNG SIArE SURCHARGE <br />ZONING ~RCHARGE <br /> <br />PAYEE; <br /> <br />rO'rAL ~ED FEES <br />PREVIOUS RECEIP1'S <br /> <br />QUAN'T'IIY ANXJUNT <br /> $~o.oo <br /> <br /> ~0.50 <br /> 0.50 <br /> <br />¢17.50 <br /> 17-50 <br /> $o.oo <br /> <br />BALANCE DUE SO.OB <br /> <br /> RECEIVED BY: P8 FYPE: C~ECK ~: 0 <br /> <br />* THiS iS A VALID PaP, MI1 ~ IHiS PERMI1 ~XPIRES 180 DAYS FROM ll~ i~E DAIE. <br />CONSFRUCIiON CEASES FOR A PaalOO OF 180 DAYS, OR iF ~Sf'~C[I~ FAILS JO ~E~[ ALL <br />RE~IRE~ENIS OF SIA'IE LA~ ~D ~RI~ G~NTY BUILDING ~D Z~ING OROIN~CE5, IHIS PEril <br />~ALL BaE~a NULL ~O VOID. <br /> <br /> SEIBACKG: FR ~0 L5 fO R~ 10 RR 30 SP <br /> RkrAARKS: CARP~.,RI ALR~J~DY STARFED.-R~4980 ....... FIELD iNSPECIOR NEE~ fO SHACK 8LOG & EVALUA[~ <br /> FOR CORRECTIONS ~, \ <br /> HEtGHI: 9 ~OIAL ~ Fl: 128 S'IO~i~: 1 PLAN.ACrid: t ~% <br /> ~NALU ~. ~OLE~, ~Ri~ C~NIY BUILDING OFFICIAL / ~Y ~ <br /> <br />FORM 0 MC 1556 REV 4/~0 OFFICE COPY <br /> <br /> <br />