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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG, NO 225 <br />220 HIGH STREET NE <br />~ALEM?OREGON 97301 <br /> <br /> PHONE: 588-5147 8:00 - 4::30 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />Other ..... <br />I na~o read and agree to the terms '~tated on tho re~er.~e s~de of <br /> <br />snd~ ADDgESS <br /> <br />UGB <br /> <br />N(,) · <br /> <br />' CATEGORY <br /> <br />OCCUPANCY <br /> <br />OCCUPANT LOAD <br /> <br />LOT RLOCK <br /> <br />SECTION TOWNSNIR <br /> <br />yALUAT ION: <br /> <br />MAP <br /> <br />IRR~G LOT ~ORNER <br /> <br />PERMIT OR APPLICAYJ, ON NO: 3383'7 <br /> <br />NIECklAN ~C~!, b ~ ~ ¥ ~ <br /> <br />P~Y~: GRiP~iN. JOLVNN <br />REC~IV~C bY: P~ <br /> <br />~HLS <br /> <br />M~L,ANCE DUE %L' ;;' <br /> <br /> iNVOICE NO; 3:~b/" <br />1YPE: C% CHECK :~: '4b <br /> <br />* 'FN1S tS A VALID PER~!t x~ THI.~, PER, lIT EXPI~ 180 OAYS FRb'M fT~ i.~SUE DATE. iF <br />C%}NSTNXJCT'ION C~/~ ~OR A PE~IO0 OF 180 0AYe, OR IF CON~T'RUCTI~,~ FAIL5 TO D!,~-T ~LL <br />~iQUiREME.~TS OF .~TATE LAW~ A~O I~,~RiON CC~JNTY ~UILDING A~D ZONING ORDtNANC515, THi~; P~II ~ <br />SHALL ~?E~E NULL AND VOID. <br /> <br />:ON.'-LJ L: 140001_~~Y, Iv!AN!ON C~-.UN Y L't~)-LL ~%.~ U .- / B"( ..... <br /> <br />REV .~/~o OFFICE COPY <br /> <br /> <br />