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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG, NO. 225 <br />220 HIGH STREET NE <br /> SAL£M, OREGON 97'301 <br /> <br /> PHONE: 588-5147 8:00- 4:30 <br /> 24 HOUR CODE-A-PHONS: 588-7904 <br /> <br /> I am performing work on a property I own PI OCCr~py. ve si NATUR P APPLICANT <br /> lamaregisteredbuiiderOR( )theauthor'zed eg~esentati G E O <br /> of a registered builder, <br /> The work will be performed by a registered guilder, <br /> Other <br /> I have read and agree to the terms stated on the reverse side of PATE; <br /> <br /> DATE~ 09/15/92 TINE: 9 :,18 :,00 <br />OW~E~'. f~ LDO'. ; dAY~sb~: <br /> FORSON, E~YflONO & P~TR~CI~ RESIDENTZ~L <br /> <br /> 11672 ~ARBLER LANE NE CONTRACT C~TY: ~ : ~UUUF~f ; <br /> ~URORA OR 97002 H~R[ON COUNTY~ NO <br /> <br /> OF BUILDIng: NO OF B~ROOMS: <br /> RE'S~OENTZRL ACCESSORY STRUCTURES <br /> <br /> S~NE <br /> SITE NUH~ER: <br /> PHOHE: 678~254 VRLU~T[OH: <br /> <br />TYPE: BUILDING PERMIT OR APPLICATION NO: <br /> <br />CONTRACTOR, NO. <br />FORSON~ RAYMOND & PATRICIA <br />ShNE <br /> <br /> 9042550 <br />ARCHITECT/ENGINEER, NO. <br /> <br />PHONE: 678-1254 PHONE= <br /> <br />TOTAL ASSESSEO FEES <br />PREVIOUS RECEIPT~ <br />THIS RECEIPT <br /> <br />BALANCE DUE <br /> <br /> ITEM <br />BUILDING FEE <br />PLAN REVIEW <br />BUILDING STARE SURCHARGE <br />ZONING SURCHARGE <br /> <br />QUANTITY <br /> <br />AMOUNT <br /> $44.50 <br /> $28.9~ <br /> $2.23 <br /> $2.2~ <br /> <br />$77~89 <br /> $0.00 <br />$77.89 <br /> <br />$0.00 <br /> <br /> PAYEE: FORSON, RAYMO~& PATRICIA 4462I <br /> REOEIVEO BY: M8_~__~____S~_~ ........... TYPE: OK CHECK ~: 2129 <br /> <br />* THIS IS NOT A A REVIEN PROCESS WHERE THE <br />FOLLO#ING MUST BE COHPLETEO. IT IS THE RESPONSIBILITY OF THE APPLICANT TO ASSURE THAT <br /> <br />HEIGHT: 12 SETBACKS: LS-~'~ <br />TOTAL SQFT: 400 .... <br />STORIES: 1 RS <br />PLAN.ACTiON: <br />ENERGY PATH: SP <br /> <br />LL NECESSARY INFORHATI',ON, HASBEEN PRO¥IDEO; <br />CITY JURISDICTION: 8Y <br /> <br />REMARKS: CARPORT AND PATIO <br /> <br />MC 15-56 REV. 4/90 <br /> <br />OFFICE COPY <br /> <br /> <br />