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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 am performing work or~ a property I own or O¢CVDY <br /> I am a reglstered bui~er OR tho authorized represen 8 ire <br /> of a registered builder, <br /> Tile work will be performed by a registered builder. <br /> Other <br /> I have read and agree to the terms stated on the reverse side of <br /> <br /> DATE: 08/;].8/92 TINE: 1!:58:44 <br />:OWNER: VAFAKOS, KAREN P TAX LOT: <br /> <br /> 11005 JANES WAY <br />AUMSVILLE <br /> <br />OR <br /> <br />:use or .u~L~J~i~.'SiDENTIAL ACCESSORY STRUCTURES <br /> <br />~ON~fRLIOflbN TYPE; : OCCUPANCY: <br /> i OCCUPANT LOAD: <br /> <br />PHONE: <br /> <br />CAHELLIA HEIGHTS b~ <br />VALUATION: $6~200.00 <br /> <br />EOT; <br /> 11 <br /> <br />;BLOCK: SECTIdN: <br />DEPTH: :AREA: ,UNIT,: IR~e. LO~: : ~'~ <br /> <br />TYPE: 8UILDIN8 PERMIT OR APPLICATION NO: <br /> <br />CONTRACTOR~ NO. 26905 ~_~.~_~. <br />Jackman Construction Zoo <br />557.5 Radell Or SE / ....... / .... <br />Salem, 97~02-0000 <br />PHON~: 564-6520 <br /> <br /> ITEM <br />BUILDING FEE <br />PLAN REVIE~ <br />BUILDING STATE SURCHARSE <br />ZONING SURCHARGE <br /> <br />PAYEE: Jackman Construction Inc <br /> <br /> 9041995 <br />ARCHITECT/ENGINEER~ NO. <br /> <br />PHONE: <br /> <br />TOTAL ASSESSED FEES <br />PREVIOUS RECEIPTS <br />THIS RECEIPT <br /> <br />QUANTITY <br /> <br />AMOUNT <br /> $62-50 <br /> $40.63 <br /> <br /> $3.13 <br /> <br /> $0.00 <br />$109.39 <br /> <br />BALANCE DUE $0.00 ~ <br /> <br />44042 <br /> <br />FOLLOWIN8 "UST BE COMPLETED. IT Z8 THE RESPONSIBILITY OF THE APPLICANT TO ASSURE THAT <br />LL NECESSARY INFORMATION HAS BEEN PROVIDED. <br /> <br /> ZONING: BY .~._~ ..... OAI'EZZ'~C~_~',,~,,~Z~_-.;'- TOTAL SQ FT= 81.6 LS'"'T'U~ <br /> <br /> PLAN.ACTION: ~7~-/¢~ RR~ <br /> C~TY ~URZSDIOTZON: BY DATE ENERGY PATN: /p~ <br /> REMARKS: GARAOE <br /> <br />OFFiCECOPY <br /> <br /> <br />