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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 />other <br /> <br />this document <br /> <br />OWN [2~A~ E: tl/01/9t <br /> <br /> AU~EVILLE OR 9'7325 <br />u~s OF ~d,~.b~O ....... <br /> <br />57706-000 <br /> <br />J NO l <br /> <br />MA~LING ADDRESS RESIDENrTAL ACCg~C~3Ry " '" -" <br /> S RUCrURE5 SU,~D~,S,ON <br /> <br />i O~OUPANT LO~1 <br /> <br />F;VbRGREEN ~'I'AT-E~ <br /> <br />PHON~: 749-3245 ~llE NURSER: 14020 <br /> VALUAFiON: <br /> <br />~l T I AL <br /> <br />35 25 8,9 2W k'~ · * <br /> <br /> fYPE; ~UiLDiNG <br /> <br />CONIRAC]OR, NO. <br /> <br />PERfVllr OR APPLiCAF'iON NO: <br />42256 <br /> <br /> 9036548 <br />ARCHI1ECI/ENGINE£R, NO. <br /> <br />1369 ~eri~ather Ct SE: <br />:%alem, 97306-0000 <br />PHONE: 363-1'711 <br /> <br />BUiLDiNG FbE $38.50 <br />PLAN Rg¥igN $25.03 <br />BUiLDiNG SYATE ,~URt,~ARGE <br /> <br />TOTAL A~E,~ED FEES <br />PREVIOUs RECEiPI~ <br />THI~ RECEIPT <br /> <br />$65.46 <br /> $0.00 <br />$85.4~ <br /> <br />BALANCE .CLUE $0.00 <br /> <br />PAYEE: Del ~OOrmick R.¢ 384'18 <br />RECEIVBD BY: PB "~ TYPE: ~N CHECK ~: 0 <br /> <br /> * THi~ 1~ NOT A P~R~IiT. IHI3 APPLiCATiON Md~l GO THROUGH A RENi~W PRO~E~ ~ERE THE <br />FOLL~iNG ~S[' BE ~PLEFBD. l'f iS THS R~81BILITY OF FHE APPLIC~F rD ~RE ?HAl <br />ALL NECE~A~ INPO~fI~ H~ BE~ P~ViDEO. <br /> <br />PLAN R~¥iEW: BY. ~.F_ <br /> <br />011Y JURISDICTION: BY <br /> <br />~EPfiC: BY .................. DAF6 ........................ <br /> <br />£ON~NG:.BY DAI~ ~ETBACK~: PR 10 LS 10 <br />REr4ARK$= C'ARPORT ....................... <br /> <br />HbIGHf: 11 TOTAL ~ Fl: 260 STORIES: 1 <br /> <br />R~.,10 RR 10 SP ........ <br />PL~,ACI' ION: <br /> <br />fORM # MC ~=-5e n~v 4~o OFFICE COPY <br /> <br /> <br />