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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG, NQ, 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 ooougs', <br />I am a registered builder OR th~ authorized representative <br /> of a registered builder, <br />The work will be pedormed by a registered builder. <br />Other <br />I have read and agree to the ~erms stated on the reverse side of <br />this documont. <br /> <br />0WNE~ATE ;' ~5/20/92 f' ,I'I~IE ~ '~ 3 '_- q'6; 29 : '~Ax'Fbfl ......... dAfEGORY: <br /> <br /> FISHER, RICHARD 5Y~99~014 <br />SITUS ADDRESS'. : CONSTRUCTION ~YPE: : ~CO¢~N~: <br /> <br />RESiDEN/iAI <br /> <br /> 4?0 NiCHAEL NAY ~ <br /> AU~SVtLLE OR 9'7325 <br />USE OFBUILDfNG: ~U~SVIUEE ; NO :N0.0FBEOR00MS: <br /> <br />SINGLE FA~II. LY ONELLiNGS SUeBIWSION: <br /> <br /> ~ BOX 29(3 <br /> AUIvtSVILLE OR 9?325 <br /> F~ONE: '74,9~257(5 SI'I'E NUtVlBER: 92-01915 <br />LOT: et. ocr: SErif ION'. <br /> <br />rwigT~h 2 :DEPTH:: AREA: ,_5~'" UNITS; 8~ IRREG, LOT: <br /> ;7'2 't50~ 108.00 SE NOi NO <br /> <br />TYPE: DNELL~NG <br /> <br />CONTRACTOR, NO. <br />FI~SHER. RICHARD <br />PO BOX 290 <br />AUNSViLLE OR 9?325 <br />PHONE: 749,~2578 <br /> <br /> i'f'E~ <br />DWELLING BUiLDiNG FEE <br />O~ELLING PLUIVIBiNG <br /> <br />QUANTITY <br /> <br />A~UN'T' <br /> <br /> $~59.58 <br /> <br /> !)WELLING MECHANICAL <br /> <br /> D~ELLiNG ~fA'fE ~URCHARG~ <br /> <br /> PA~E: PISHER. Ri~AR~ ~ /-~ <br /> <br />:¢ 'f'HLS }S NOT A PE~l['f. '['HJS APPL~CA'fLON ~USf' GO 'f'HROUG~ A REV~ PROCESS ~ERE THE <br />FGLLONtNG NUST BEf" '.O~PLE f ED .' ' ....... Z']' ~S THE RESPONSJBLLZTY OF' THE APPLICANT TO ASSUR~ '1'HA'~ <br />ALI_ NECE~ARY ]NF'OR~ATLON H~ BEEN <br /> <br />PLAN [REVIEW: BY...~.¢/ ............DATE.......~/4~/¢_r.__ <br /> G~'¥Y JUR1801C'I'1ON: BY <br />~P'iIC: BY DATE ENERGY PATH: <br />ZONING; 9Y DAI'E SE'I'BACK~: P'R LS RS RR <br />REMARKS: ..................................... <br /> <br />HEIGHT: <br /> <br />DAlE <br /> <br />D~EEE.'I~G .................................................... <br />2~ I'G'T'AL SQ FT': 2720 5']'ORI~S: 2 PLAN.ACTiON: <br /> <br />FORM # MC ~-,~ ~EV. '~0 OFFICE COPY <br /> <br /> <br />