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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 performing WOrk on a property I own or ocougy, <br />I af~ a registered builder OR the authorized represen a ive <br />of 8 registered builder, <br />The work will be performed by a registered builder, <br />Other <br />~ have read and agree to the terms stated on the reverse side of <br />thi8 dooument, <br /> <br />· bWNE~'F~= 04/10/92 <br /> <br /> · PO'!'HE'rE$, <br />SITUS ADDRESS: <br /> <br />15:03~28 <br /> <br /> 270 EVERGREEN OR <br /> AUMSVi LLE OR 9?325 <br /> <br />USE OF BUILDING <br /> <br /> 5 ? ? 08-000 4E~ I DEN'T' T A <br />CONSTRUCTION TYPE OCCUPANCY <br /> <br />AUIV~ILLB .. NO <br /> <br />MAILING AbDRESSi RE~I~FiAL ACOE~ORY Sr'RUOTURES sueo~ws~oN <br /> <br />EVERGREEN ES'fAf'ES ~H PARK <br /> <br /> PHONE: <br /> <br /> LOT. BLOOK SECTION TOWNSHIP <br /> <br />.... 7 25. <br />WIOTM' ,DEPTH'· AREA UNITS; <br /> 58 85 <br /> <br />~I'IE NUMBER: 92-01389 <br /> VALUAT i ON: $3,12r0.00 <br /> <br />85 <br /> <br />SF <br /> <br />LOT COSNES: <br /> NO <br /> <br />TYPE: BUILDING <br /> <br />CONTRACTOR, NO. · <br />POTHE'f'EB, NiCK <br /> <br />PERMIT OR APPLiCATiON NO: <br /> <br /> 39209 <br />AR~HI'T'ECT/ENGiNEER, NO. <br /> <br />PHONE: PHONE: <br /> <br /> iTEM <br />BUILDING FEE <br />PLAN RE¥iEN <br />BUILDING STATE ~AJRCHARGE <br /> <br />PAYEE: <br />RECEIVED BY: P8 <br /> <br />f. XJANT'ITY AMOUN't: <br /> <br /> 28.93 <br /> $2.23 <br /> <br />TO'FAL A2$.SE~ED FEED <br />PREVIOUS RECEIPTS <br />THIS RECEIPT <br /> <br />$75.66 <br />$75.66 <br /> $0.00 <br /> <br />BALANCE DUE $0.00 <br /> <br /> TYPE: CHECK ~: 0 <br /> ........................................................................ ;i]i'--]%~ .................................... <br /> * 'f'HI5 I8 A VALID PERMIT $ THiS PERMIT EXPIRES 180 BAYS FROM ITS i~E DATE. iF <br />CONS'f'RUCfIC~ CEASES FOR A PERIOD OF 180 DAYS, OR iF CONST~CrzON ~AiL..~ TO MEE'~ ALL <br />REQUIREMENTS OF STATE LAMS AND MARION COUNTY BUiLDiNG AND ZONING ORDINANCES, THiS PERi'4i~' <br />~ALL BBC~ME NULL AND VOID. <br /> <br />ENERGY PAI'H: <br /> <br />SETBACKS= FR 10 LS 10 RS 10 RR 10 SP <br />REMARKS: CAR,Of3R'f ..................... <br /> <br />HEIGHT: 11 TOTAL SO F']': 312 STORIES: 1 <br />DONALD E. ~OODLEY, MAR~ON COUNTY BUILDING OFFZOiAL /' BY <br /> <br />PLAN.ACTiON- <br /> <br /> OFFICE COPY <br />FORM ¢ MO 15-58 REV. 4/9o <br /> <br /> <br />