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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 /> 0A'f'E: 06/24/92 TINE: ]2:42:16 <br /> ........................ i t~(' 'E6~'. I CAteGOrY: ' <br /> BLAN, 0~ ~ DEBORAH <br /> <br /> 120 ~P~CE CT <br /> AU~V1LLE OR 97325 <br /> <br /> -' '--- ssso <br /> <br /> ~ VA~AT [~: $2,400.00 <br /> <br /> 55 92~ 5060. SF ~ NO ~ NO <br />......................................... L ........................~ ~ ......................... <br /> <br />TYPE: BUiLDiNG PERNiT OR APPLICATION NO: <br /> <br />CONTRACTOR, NO. <br />BLAN, DAN & D~BORAH <br />SAME <br /> <br /> 9040846 <br />ARCHITECI'/E~GINEER, NO. <br /> <br />PHONE: 769-3100 PHONE: <br /> <br />BU[LDtNG FEE <br />RLAN RE¥IE~ <br />BUILDING STATE ,~URC~ARGE <br /> <br /> OUAN T I TY <br /> <br />TOTAL A~EO FEE~ <br />PREY I r0US RECEIPTS <br />THIS RECEIPT <br /> <br />BALANCE DUE <br /> <br /> AIviOUNI' <br /> <br /> 25.0~ <br /> $1.93 <br /> <br /> $65.46 <br /> <br /> B5.46 <br /> $o.oo <br /> <br />428?5 0 <br /> <br /> PAYEE: BLAN, DAN & DP_~ORAF <br /> RECEIVE0 BY: ~ TYPE: iN CHECK ~: <br /> <br />* THIS iS NOT A PERM11'. TB~S,APPLiCAT~ON,,MUST GO THROUrSH A REVIEN PROCESS NHERE THE <br />FOLLONING NUST BE C%)f~PLETED; ['f i~ THE R~%-'~PONSIBILITY OF 'THE APPLIC~'I' TO ~5URE 'f'HAl <br /> <br /> P~ REVi ~: r ~, . . <br /> cIl'Y JURiBDICl'I~: BY ................................ <br /> SEPTIC: BY ............................................ ~ATE .................................... ~Y PATH~ <br /> <br /> Z~NG: BY DATE 8ETBAOK$: ;R 10 L~ 6 ~ / RR 10 SP <br /> R~MAR~: C~R~RT'T'"'[THERE"'I~-$"~ISTiNG ~R~RT ~ P~P[R'FY'"'A~.'-' <br /> <br />'HEIGHT: 10 TOI'AL~ F"T': 240 STORiES; 1 <br /> <br />PLAN.ACTION: <br /> <br />OA'I'E ................................ <br /> <br />ro.u # ~c ~s-~ ~Ev. 4/~o OFFICE COPY <br /> <br /> <br />