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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 e property I own or oCCupy, <br />~ am a registered builder OR the authorized representative <br />of a registered buiidee <br />The work will be performed by e registered builder. <br />Other ,,, <br />I have read and agree fo the terms stated on the reverse side of <br /> <br /> 'rAu'm~s'r, HANK <br /> <br /> 13710 cEDAR C'f 'NE <br /> AURORA OR 97002 CONTRACT CitY: UGf~: , OCCUPANT LOAD: <br /> <br />!d§~ o~ ~d~Lb~ ..................................... <br />!'~Ag-i~6 AObR'Ess; ;SUBDiviSiON; <br /> <br /> PHONE.' ~ ~ITE NUMBER: 92'~01075 <br /> VALUAT [~: $0. O0 <br /> <br />WIDTH; ~?ODEPTH; 229JAR~A: 61830. {['~'~i~ ~F ~RR~G. LOT; NO J CORN~Rv~ <br /> <br />R~IDENTiAL <br /> <br />TYPE: BUILDING PE~i'r OR APPLICATION NO~ 38?72 <br /> <br />OONTRACI'OR, NO. 46~73 <br />O,~rvid 0 6anber <br />4475 S Timbem Trail Dr <br />V'k:)o~bMrn, 97071~870g <br />~E~ 634-2490 <br /> <br />ARCHiTECT/ENGiNEER, NO+ <br />PHONE= <br /> <br /> i'rE~ <br />ADDITIONAL BUiLDiNG FEE~ <br />ADDITIONAL SURG~ARGE~ <br /> <br />QUANTITY AMOUNT <br /> $25.00 <br /> $1.25 <br /> <br />TOTAL AE~ED FEE~ <br />PREVIOUSRECEiP'r$ <br />THIS RECEIPT <br /> <br />$26.25 <br /> $o,oo <br />$26.25 <br /> <br />BALANCE DUE $o.o0 <br /> <br /> PAYEE: D~vld D 6enbeP ,~. 40775 <br /> RECEIVED BY: c~ TYPE: CK CHECK ~: 2456 <br /> <br />* THIS IS A VALZO PE~iT ~ ~HIS PE~IT ~PIR~ 180 DAYS F~ ['rs i~E DATE. IF <br />~ST~CTI~ C~ ~R A PERIOD OF 180 DAYS, OR iF ~ST~Cl'i~ FAI~ ']'O ~EET ALL <br />RE~IR~TS OF STATE ~,~D ~R[~ ~NTY BUILDING ~O Z~[NG ORDiN~C~, THIS PE~IT <br />~ALL ~E~ NULL ~D <br /> <br />REf~RKS~ FOUNDATION ION-ORE? PERf~T-'- <br /> <br />HEIGHT: TOTAL ~ FT; 0 STORI'~ <br /> <br />0ONALD E. ~OODLEY, MARION COUNTY BUiLDiNG OFFICIAL / BY <br /> <br /> OFFICE COPY <br />FORM # MC 15-56 REV. 4/90 <br /> <br /> <br />