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MARION COUNTY BUILDING INSPECTION <br />SENATORBLDG NO 225 <br />220 HIGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br /> PHONE:: 588-5147 8::00 - 4;;~0 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />SIGNATURE OF APPLICANT <br /> DATE <br /> <br />[35/18/91 <br />JOHNSON, <br /> <br /> 'TIME: 10;11:15 <br />FRANCI~ <br /> <br />DE1 ROI T <br /> <br />OR 97342 <br /> <br /> TAX [OT <br /> 90220-?90 <br /> CONSTRUCTION TYPE <br /> <br />CONTRACT CITY 5~'~ <br />DEIROit NO <br /> <br />CATEGORY <br />OCCUPANCY <br />OCCUPANT <br /> <br />MA,WNO ADB~FSS 5¥RUCfURP.~ orDER THAN BUILDINGS <br /> <br />P_O. WOX 591 <br />D~TRDiI , OR <br /> <br />SiTE NU~ER: 13313 <br />VALUA [ J. ON: $1 ,. 200. <br /> <br />8 ? 2O <br /> 50 100 5000. <br /> <br />10 5E <br /> IRREG LOT CORNER <br /> <br />SF' NO NO <br /> <br />TYPE: 80 ILDING <br /> <br />GONIRAC¥OR, NO. <br />J~N~, FRANCI5 <br />P.O. 8OX 591 <br />DETROIT, OR <br />PHON~: <br /> <br />PER, If' OR APPLICAIiON NO: 9083045 <br /> <br /> ARCHITECT/ENGiNEER, NO. <br /> <br /> 1TEJ~I <br />BUILDING <br />PLAN REVIEW <br />BUIlDiNG <br /> <br />PAYEE: J(]~qN~, FR/NNCiS <br /> <br />PHONE: <br /> <br />'TOTAL AS~ED FEES <br />PREVIOUS R~OEIPIS <br />THiS RECEIPT <br /> <br />BALANCE DUE <br /> <br />QUANIllY <br /> <br />A~OUNI <br /> $20_50 <br /> $t3,33 <br /> $1.03 <br /> <br />$34_86 <br /> $o.oo <br /> <br />$0_00 <br /> <br />84846 <br /> <br /> RECEIVED BY.* PR 1YPE; IN CHECK ~: 0 <br /> <br />~ THiS iS NO1 A PER~li'T. THiS APPLiOAIlON r4uST GO I'H~GH A REVI~ P~ ~ERE ]H~ <br />POLL~ING ~Sr BE ~PLETEO. I[ iS THE R~SiBiLITY OP' f'HE APPLIC~F lO A~URE THAT <br />ALL NECE~ARY INPO~Ii~ HA5 BEEN P~VIDED. <br /> <br /> CiTY JURiSDiC'TiON: BY <br /> <br />BEPfiC: BY ...... DATE ..................... <br /> <br />ZONING: ~Y DATE SEIBACK5: PR 20 L5 5 RS..5 RR 5 DP <br />REIqARK.5: REROOF'MOBiLE HOC4E <br /> <br />HEIGHT: O [OTAL ~q Fl: 0 5fORiESz 1 RLAN_ACflON: <br /> <br />DATE <br /> <br />FORM # MC 15-8~ R6¥ 4,90 OF FICE COPY <br /> <br /> <br />