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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 /> 24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />I am a registered builder OR ( ) the authorized representative SIGNATURE OF APPLICANT~ <br />of a registered builder. <br />The work will be performed by a registered builder, <br />Other <br />i have read and agree to the terms St,ted on the reverse side of <br /> <br />· c,W~¢:f:Et 06/10/92 <br /> <br /> BUTLER, DAVID <br />SITUS ADDRESS: <br /> <br />TAX LOT; <br /> <br />CONSTRUCTION TYPE[ <br /> <br /> 99?8 S'I'AY'I'ON ROAD SE <br /> AUF'iSV i LLE OR 97325 <br /> <br />use (DF BUILDING'. <br /> <br />, CONTRACT CITY; UGJ~: <br />: ~IARI ON .COUNI'¥ i NO <br /> <br />CATEGORY: <br /> RED i DEN T 1 ,M <br />OCCUPANCY: <br /> <br /> R-3 <br />OCCUPANT LOAD~ <br /> <br />i~A~LiNGADD~ESS; SJ. NGLE F,C,~iEY ONELL'iNr3._~ <br /> <br />SUBDIVISION~ <br /> <br />~YORK 769-5503 <br />PHONE: ?69-?822 <br /> <br />LOT: <br /> <br />WIDTH: DEPTH: <br /> <br /> S,[TE NUMBER: 92-01482 <br /> VALUA'F IC¢4: $0.00 <br />SECTIdN: TOWNSNIP; RANGE: zone; MAP: <br /> <br />AREA: UNITS: ' <br /> 12? . AC YES NO <br /> <br />50 <br /> <br />TYPE: BUiLDiNG <br /> <br />CON'T'RACTOR NO. <br />BUTLER, DAVID <br /> <br />PERMIT OR APPLICATION NO: 9040549 <br /> ARCHiTECT/ENGiNEER, NO. <br /> <br />NORK ?69-5503 <br />PHONE: 769-7822 PHONE: <br /> <br /> i'f'EFI QUAN'f'~'I'Y <br />OEMOLITION 2 <br />BUILDING STATE ~URCHARGE <br />ZONJNG SURCHARGE <br /> <br />PAYEE; BUTLER, OAVt0 <br />RECEIVED BY: ~ <br /> <br />TOTAL A~S~EB FEES <br />PREVIOUS RECEIPTS <br />THiS RECE[P'f' <br /> <br />AJ'4C)UN ]' <br /> $15.oo <br /> <br /> $0.50 <br /> <br /> $0.00 <br />$15.00 <br /> <br />BALANCE BtJE $0.00 <br /> <br /> 42583 <br />TYPE; OK CHECK ~: 1987 <br /> <br />* I'Hi,S I5 NOT A PER]vIII'. I'HiS APPLICATION IvluE,'I' (50 THROUGH A REVIEW PROCE~E, ~"~ERE f'HE <br />prOLLr.3~ING fv[~JE,'f' BE COr4PLB'T'ED. iT IS THE R~PON~IBILi'I'Y OF THE APPLICANT 'FO A~URB THAT <br />ALL NECE~O~ARY ,[NF'ORIVI~ ' <br /> HA8 BEEN PROVIDED. <br /> <br /> PLAN RE¥i E~: ........................ DATE <br /> SEP'[ J,C: BY '¢ / O¢'TE ENERGyCiTY JURISDiCTiON:PATH: BY ................................ DATE ................................. <br /> <br /> ONiN , ......... <br /> REMARKS: DE~-'~'2"STOR[ES ~ ......................................... <br /> <br /> HEIGHT: 22 TOTAL SQ Fi': 1600 STORI~: 2 PLAN.ACTiON: <br /> <br /> OFFICE COPY <br />FORM # MC 15.56 REv'. 4/90 <br /> <br /> <br />