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MARION COUNTY BUILDING INSPECTION <br />SENATORBLDG NO. 225 <br />220 HIGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br /> PHONE:: 588-8147 8::00 - 4;30 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />Othe~ <br /> <br />I ha~e read and agree to the terms stated on the reverse side of <br /> <br />SIGNATURE OF APPL. ICANT <br /> DATE <br /> <br />OwN~A]'g: 03117/92 <br /> MiNARD, REX <br />S}TUS ADDRESS <br /> <br />TIME: 9:42:39 <br /> <br /> ??35 AU~ViLLE Hif~NAY <br /> AUD~Vi LLE OR <br /> <br />USE OF BUILDING <br /> <br />9?325 <br /> <br />SE <br /> <br />TAX LOT <br /> <br />CONSTRUCTION TYPE <br /> <br />CONTRACT CITY UGB <br />~RiON OOUN f Y <br /> <br />NO <br /> <br />CATEGORY <br /> RESIDEN1 IA <br />OCCUPANCY <br /> <br />OCCUPANT LOAD <br /> <br />MAH. ING ABDRESS SINGLE F~ILY DNELLiN~ <br /> <br />SUBDIVISION <br /> <br /> SAME <br /> <br /> PHONE: 3?8-?239 <br /> <br /> 23 8S <br />WIDTH DEPTH AREA UNITS <br /> 0 0 6.1 AC <br /> <br /> Si1E NU~ER: 92-00959 <br /> VALUAF ION: $4,500. oD <br />RANGE ZONE MAP <br /> <br /> 2W AR <br />IRREG LOT CORNER <br /> NO NO <br /> <br />49 <br /> <br />CONtRACtOR, NO. <br />IgJR1 1H~ <br />3941 IBEX Sr NE <br />SALEM, 9?305 <br />PHONE: 393-2933 <br /> <br />PCklv111 OR APPLiCATiON NO: 38564 <br />63789 ARcHIrECT/P]WGtNEER, NO. <br /> <br />BUILDING FEE <br />PLAN REVIEW <br />BUILDING STATE SURCHARGE <br />ZONING SURCHARGE <br /> <br />PHONE.+ <br /> <br />TOTAL ASSESSED FE~ <br />PREVIOUS RECEIPTS <br />THIS R~'CEi PI' <br /> <br />QUANIi1Y AlaN1 <br /> $50.50 <br /> $32.83 <br /> <br /> $88.39 <br /> $o.oo <br /> <br />BALANCE DUE $0.00 <br /> <br /> PAYEE: !~.~._~. <br /> RECEIVED BY: MB TYPE: CHECK ~: 0 <br /> <br />~ THiS iS A VALID FERMI1TM rHzs PERMII EXPiRP.~ 18o DAYS FRCM ils I~UE DALE. IF <br />CONSFR1JC'riON C,EA~ES FOR A PERIOD OF 180 ~YS, OR iF ~Sr~OfI~ FAILS TO MEET ALL <br />R~IREMENI5 OF S1A1E ~ ~O ~Ri~ C~N'iY BUILOIN6 ~D Z~ING ORDIN~C~, THiS PERNI1 <br />~ALL BEdE NULL ~D VOID. <br /> <br />SE1BACICS: PR 20 LS lO RS 10 RR 30 SP <br />RBVlARKS: GAP, AGE APPROVESD"FOR NORCOfqC4ERCIAE'-USE ONLY <br /> <br />HEIC441: 10 TO1AL SQ Fl': 864 STORIE~: 1 <br /> <br />OONALD E. ~Y,)ODLE~, MARi(}N C~N1Y BUtLOiNG OFFICIAL / BY <br /> <br />PLAN. ACI I ON: <br /> <br /> OFFICE COPY <br />FORM ~ MC 1 ~-58 REV 4/90 <br /> <br /> <br />