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MARION COUNTY BUILDING INSPECTION <br />SENATORBLDG 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 />lam a registered builder OR( ) the authorized representati*ce <br /> <br />The work will be performed by a registered builder <br />Other <br /> <br />SI(~NATURE Off APPLICANT <br /> DATS <br /> <br />:OWN'L~rE: 04/01/92 TIr4E: 1~,;49:28 <br /> <br /> PALAN IUK, t~k%~ARE r <br /> <br />TAX LOT <br /> <br />CONSTRUCTION TYPE <br /> <br /> 9963 MiLL CREEK RD SE <br /> ADIS)SVi LLE OR 97325 <br />USE OF 9UILDING <br /> <br />C6NT~A~Y 6iT~ <br /> <br />IvIARi ON COUNTY <br /> <br />MAILING ADDRESS ' ~):l'~Gii-E F/~li-g4( [~BLLiNf..'~.~~ <br /> <br />'- NO <br /> <br />CATEGORY <br /> <br /> RESIDEN1 iAL <br />OCCUPANCY <br /> <br />OCCUPANT LOA~-3 <br /> <br />NO OF BEOR00MS <br /> <br /> PHONE: '149-2882 <br /> <br />LOT BLOCK <br /> <br /> SIIE NUrflBER: 92-01188 <br /> VALUAtiON: $12,600.00 <br />SECTION TOWNSH I¢ R~NGE ZONE MAP <br /> <br /> AREA 31 UNI~S 8S iR~E~ ~GT ' 't~ :CORNER BPU <br /> <br />..54~ 13'1088. ~F ..... NO NO <br /> <br />48 <br /> <br />f'YPE: BUiLDiNG PEF¢411 OR APPLiCATiON NO: <br /> <br />CON FRAC rOR, NO. 51325 <br />D Sffmp~on <br />4340 G'l~wood Dp SE <br />Sa I®m, 9'1301-0000 <br />PHONE: 362-3813 <br /> <br />BUiLDiNG FEE <br />PLAN REVIEW <br />BUILDING $'FAFE SURCHARBE <br />ZONING SURCHARGE <br /> <br /> 38894 <br />ARCHIrEC¥/ENGiNEER, NO. <br /> <br />TOTAL ~E.I~ED FEES <br />PREVIOUS RECEIP1~ <br />THiS RECEIPt <br /> <br />~UANTIIY AMOUNT <br /> ~98.50 <br /> 64.03 <br /> $4.93 <br /> $4.93 <br /> <br /> $0.oo <br /> <br />BALANCE DUE $0. O0 <br /> <br />PAYEE: ~& <br />RECEIVED BY: r4B t .................................................................. 1'YPE; CHECK <br /> <br />· ]'HIS iS A VALID PERi, il m ]'HIS PER~iT EXPIRES 180 DAY5 FROr4 iTS I~E DALE. IF <br />coNsmucrioN CEASES FOR A P~R1OD OF 380 DAYS, OR IF CONSfRUOTiON FAILS 'tO MEEI' ALL <br />REQUIRERENfS OF S'IAIE LA~5 AND MARION COUN.1Y BUILDING AND ZONING ORDINANCES, lHiS PERMi] <br />SHALL BECONE NULL AND VOID. <br /> <br />ENERGY PATH: <br /> <br />SE1'OACKS: PR ~ LS 10 RS ~ RR ~ SP <br />R~RK.~: FANILY FFJ(.?~I ADDiTiON <br /> <br />DONALD E. V¢30DLEY~ MARION ~N~'Y BUILDING OFFIC&AL / 8Y <br /> <br />PLAN.AC f ION: <br /> <br />OFFICE COPY <br /> <br /> <br />