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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::30 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />SIGNATURE OF APPLICANT <br /> DATE <br /> <br />O,,,,N~.¢, I E: <br /> <br /> 5AN'f lAM HOMES <br /> <br />I'IME: 9:46:32 <br /> <br /> 210 E",/ERGREEN DR <br />AUIVL%V I LLE OR 9?325 <br /> <br /> TAX LO( <br /> <br /> CONSTRUCTION TYPE <br /> <br />1 CONTRACT CITY <br /> <br /> AU~V,~ LLE <br /> <br />5-N <br /> UGB <br /> <br />NO <br /> <br />CATEGORY <br /> RgSI L)gN l 1AL <br />OCCUPANCY <br /> <br />OCCUPANT t <br /> <br />RESi DENt IAL A(."f~E~RY STR'tJC lURES SUeDIvlSlON <br /> <br />1]373 MILL CR <br />AtJ fv'CSV [ LLE <br />PHONS: 'f69--7744 <br /> <br />EYERGREP~ IVlH gSTAIE5 <br /> <br />SIIE NUI'48ER: <br /> VALUA r 1 ON: <br /> <br /> 13O67 <br /> $2,000.00 <br />ZONE MAp <br /> <br />0. NO NO <br /> <br />BUiLDiNG PgRMiI OR APPLICAFiON NO: <br /> <br />CONIRACTOR, NO- 38238 <br /> <br />113/3 ~tLLCREEK RD SE <br />AUIVY, SV~LLE OR 97325 <br />PHUNE: 789-7'~44 <br /> <br /> 9033141 <br />AR(.,~I1ECI/ENGiNEER, NO. <br /> <br />PHONE: <br /> <br /> IFEM Q~UANIlFY AMOUNI <br />~UiLDiNG FEE $32.50 <br />PLAN REVIEW <br />BUILDING STA~E ~URCHARGE $1.b3 <br /> <br />TOIAL ~E.~L%'ED FEES <br />PREVIOUS RECEIPTS <br />tHiS RECEIPT <br /> <br />$55.25 <br /> $0_00 <br />$55.2~ <br /> <br />BALANCE DUE $0,00 <br /> <br /> PAYEE: 5ANIIAN MO~iLE HOfflES 34944 <br /> RgL;~,iVED BY: PR fYPE: iN CHECK ~: O <br />* IHlb i5 NOI A PERMiI+ 'lHlS APPLiCATiON IvlUS! GO THROUGH A REVIEW PROCESS ~HERE <br />HDLLOWiNG ~USf BE COMPLEf~O. if 18 THE RESPON~ISiLiIY OF FHE APPLiCANf fO A~3~JRE THAf <br />ALL NECESSARY INFORMAI~ON HAS BEEN PROVIDED. <br /> <br />5EPl iC: ~Y DAlE <br /> <br />Z(~iNG: 8Y DAlE SEIBACK5: <br />REMARKS: GARAGE ...... <br /> <br />HEIGHI: lO TOfAL 5Q Fl: 390 <br /> <br />CIIY JURiSDICI[ON: BY DAIE <br /> <br />PR 10 L5 10 RS 10 RR l0 5P <br /> <br />SIORIES: I PLAN.AC¥i0N: <br /> <br />FOn~ ~ ~c ~s-s~ REV ,~/9o OFFICE COPY <br /> <br /> <br />