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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 8m performing work on e property I own or occupy. <br /> I am a registered builder OR { ) the authorized representative <br /> of a registered builder. <br /> The work will be performed by a registered builder. <br /> Other <br /> i have read and agree to th'~ term~ sta~d ~ the reverse side of <br /> this document. <br /> <br /> OATE: 0r5/24/92 'r !r4E: <br />OWNER: <br /> EMERY, ADRIAN C. JR. & JANET E. <br /> <br />SITUS ADDRESS~ <br /> <br /> 130 LAKECRES'I' OR <br />OE'I'RO I T OR 9?342 <br /> <br />USE OF BUILDING; <br /> <br />MAILING ADDRESS: SINGLE F.aPliLY D~ELLI. N~ <br /> <br />TAX LOT: <br /> 90250-020 <br /> <br />CONSTRUCTION TYPE' <br /> 5~N <br />CONTRACT CIT JGB. <br />DE'T'ROI 'T NO <br /> <br />guBDrvIsION: <br /> <br />PATTON APB <br /> <br /> PO BOX 439 <br /> AU~VILLE OR 97325 <br /> PHONE: '149-2624 SiTE NU~IBER: <br /> VALUA'r ! ON: <br /> <br />LOT BLOCK: SECTION: TOWNSH IF; RANGE <br /> 3 1 01 10 5E <br />WIDTH: DEPTH AREA UNITS RREG. LOT: <br /> 92 1 ?8 163?6. BP' NO <br /> <br />'CATEGORY: <br /> RES 1 DEN 1 i,¢ <br /> <br />OCCUPANCY. <br /> <br />OCCUPANT LOAE <br /> <br />NO OF BEDROOMS <br /> <br /> 92-01760 <br /> $50.000.00 <br /> <br />CORNSR <br /> NO <br /> <br />TYPE.* b~NELLING PERMIT OR APPLICATION NO: <br /> <br />CON'I'RAC']'OR, NO. <br />EMERY, ADRIAN C. ,JR. & JANET <br />PO BOX 439 <br />AUMSVILLE OR 9?325 <br />PHONE: 749-2624 <br /> <br /> iTEM <br />L~ELLiNG BUILDING FEE <br />B~ELLING PLUIV~ING <br />DIAIELLING MECHANICAL <br />D~ELLING ELEC'f'RiCAL <br />DWELLING 51Al'E ,SURCHARGE <br />DWELLING PLAN REVIE~ <br /> <br />PAYEE: <br /> <br /> 39849 OR <br />ARCHITECT/ENGiNEER, NO. <br /> <br />I'OTAL ~ED FEES <br />PREVIOUS RECEIPTS <br />'I'HIS RECEIPT <br /> <br />(~XJAN'f I TY <br /> <br />AFDUN'T <br /> <br /> !57.03 <br /> 14.21 <br /> <br /> $15.51 <br /> <br />$4Y0. <br />$4 ? 0. ? ? <br /> $0.oo <br /> <br />BALANCE DUE $o.0o <br /> <br /> RECEIVED BY: F-'B ................................................................. TYPE: CHECK ~: 0 <br /> <br />~ THiS iS A VALID PERMIT ~ 'THIS PEr'lIT P_~XPiRES 180 DAYS FROM iTS i&SUE DATE. iF <br />CONSFRGC'FION CEASES FOR A PERIOD OF 180 DAYS, OR iF OONS'FRtJCTiON FALLS 'fO MEE'f' ALL <br />REQUIREMENTS OF S'T'AI'E LAWS AND MARION COUNI'Y BUILDING AND ZONING ORDINANCES, ']'HIS PERM,iT <br />SHALL 8ECC~E NULL AND VO!D. <br /> <br /> ENERGY PAT'N: 1 <br /> <br /> SE'FBAC. KS: FR 20 LS 5 RS 5 RR 15 SP <br /> RE~,AR~S: NEW'"'RES ............ <br /> <br /> H~iGH'I': TOTAL SQ F'l': 972 STORIES: 2 <br /> <br /> 0ONALO E. ~b'OBLEY, FC~ARION COUNTY BUILDING OFFICIAL / BY <br /> <br />FORM#MCI5.~R~.4~O OFFICE COPY <br /> <br /> <br />