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MARION COUNTY BUILDING INSPECTION <br />SENATOR SLDG. 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 />of ~ registered builder, <br /> <br /> The work will be performed by a registered builder <br /> Other , , <br /> i have read and agree to the terms stated on the reverse side of <br /> this document <br /> DALE: 09/'13/91 liME: 11:59:52 <br />OWNER DA1 ES, GARY TAX LOT <br />"srrb~ <br /> <br />DATE _ ......... ,= <br /> <br /> 9824 MiLL CREEK RD 5E <br /> AUfv~VI LLE OR 97325 <br /> <br /> O§~'-dF Eu~6 ....... <br /> <br />........... SINGLE FAI~H'Ly ~ELLiNGS <br /> <br /> 749~2846 <br /> <br /> 56274-000 <br /> <br />CONSTRUCTION TYPE <br /> 5-N <br />CONTRACT CITY UGS:: <br />NO <br /> <br />CATEGORY <br /> <br />i LOT ,: B L OC'~ ..... I ~ECTION <br />'~'IDIH IDEPTH <br /> <br />NO OF BEDR00M,S <br /> <br />i ~i1E NUIV~ER: 14110 <br />,' VALUAIION: $9,000.00 <br /> <br />TYPE: BUILDING <br /> <br />CONYRACIOR, NO. <br />8ALES, (&~RY <br /> <br />PEF~if OR APPLICAFiON NO: <br /> <br /> 9035139 <br />Ak%HiIECI/ENGJNEER, <br /> <br />PHr,$1E: 'Y49-28.4 b PH0f4t-: <br /> <br />BUILDING FEE <br />PLAN <br />BUILOiNG ~TATE ,~URCHAF-~ <br /> <br />r,OrAL AE~ES.~EDFEES <br />BALANCE DUE <br /> <br />QUANT T I Y <br /> <br /> ~74.50 <br /> 48.~3 <br /> $3.73 <br /> <br /> $o.oo <br />$1~6.66 <br /> <br /> $o.oo <br /> <br /> 3'1046 <br /> RECEIVED BY: P13 '~: ~ TYPE- IN CHECK ~- 0 <br /> <br />rULL~ZN~ ~S BE O~PLEFED,: I l iS T~E RE%~SIBILiTY OF tHE APPLiCANI fO ~RE IHAf <br />ALL NEC6~RY iNPO~f~ <br /> <br /> ::~/~ ;' CItY JO~[SDICfi~; BY DATE <br /> <br />SEP)iC: BY DAT~ . : , , <br /> <br />ZONING: BY DAVE ', -:~'I'BA~KS: .FR <br />REMARKS: COi~VERTING GARAGE-I'O-F;N'~I,ILy ~, BAFH ~]0TILi Y-~ <br /> <br />RS RR SP <br /> <br />IOTAL ~ Fl: <br /> <br />0 510R1~5: 2 PLAN_ACfiON: <br /> <br /> <br />