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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG, NO. 225 <br />220 HIGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br /> · ' · :' 'PHONE:588-5147 8:00- 4:30 <br /> · ~ 2z~ HOUR CODE-A.PHONE 588-.7,904 <br /> <br /> I am 8 registers,4 bui[der OR ( ) the authorized representative SIGNATURE OF APPLICANT; <br /> <br /> The'work will be performed by a r~gi$?red builder,'" :' : :: .... <br /> <br /> ;':;:' ........ : ...... .......... <br /> <br />WI ~VILLE~ OR 97070 ~ , <br /> .. ~ VALUA'F l~: $4 800.00 ~: <br /> <br />CONTRACTOR, NO. 67318 <br />Rick Rudffshauser <br />5458 ~ee Dr <br />Au~vllle. 97225-0000 <br />~E: 585-2684 <br /> <br />ARC~i'T'ECI'/ENGiNEER, NO. <br /> <br />~; THIS I8 A VALID <br />CONS'FRUOTfON OF_.JA~EL~ FOR <br />REQUiRENENTS OF STATE <br />SHALL BECONE NULL .Z~ID VO,[.D.i <br /> ., <br /> <br />~3U[LDING FEE ! $50.5U <br />PLAN RE~/IEIN $32.83 <br />BUILDING STATE SURCHARGE ;. $2.53 <br />Z~ING ~A~E $2.55 <br /> <br /> $88.3g <br /> ?$'S $88.39 <br /> $0_ 00 <br /> <br /> $o_ co <br />PAYEE: <br />RECEIVED BY: CL ~ECK ~; 0 <br /> <br /> ~ iTS [~E DATE. iF' <br /> T[~ FA~L~ 70 ~EE'f' ALL <br /> ~D:Z~NG ORDiN~CES. f'HIS PEI~.[T <br /> <br />~ALD E. ~DLEW, ~R[~ ~NTY BUiLDiNG OFFICIAL / BY <br /> <br />OFFICE COPY <br /> <br /> <br />