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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 />of a registered builder, <br />The work w I be performed by a reg s e ed builde <br />Other, <br /> <br />this document, <br />CATE: 07/24/92 TIHE: i2:44:55 <br />CARRY, DON & HELEN <br /> <br /> 11044 JAMES WAY DRIVE <br /> AUNSVILLE OR <br /> <br />: SINGLE FAMILY DWELLINGS <br />'~AILING ADDRESS; <br /> <br />SE <br /> <br />PHONE: <br /> <br />SIGNATURE OF APPLICANT~ <br /> DATE: <br /> <br />$~¥ LOT' <br /> 2600 <br /> <br />CONSTRUCTION tYPE. <br /> <br /> 5~N <br /> <br /> COUNTY <br /> <br />UGB <br />NO <br /> <br />CATEGOR/ <br /> RESIDENTIAL <br />OCCUPANCY: <br /> <br />OCCUPANT LOAD: <br /> <br />SUBDIVISION <br /> <br /> ACNELLIA HEIGHTS <br /> <br /> SITE NUMBER: 92-02727 <br /> VALUATION: $6,500.00 <br /> <br />:' LOT: i BLOCK; SECTION; TOWNSHIP <br />: 9 . ~ 29 8S <br />WIDTH; iOEPTH: ; AREA; UNITS: <br /> <br />RANGE ZONE <br /> <br /> qREG. LOT CORNSF <br /> NO NO <br /> <br />MAP <br /> <br />TYPE: 8UILOIN6 PERMIT OR APPLICATION <br /> <br />CONTRACTOR, NO. 35052~ ¢ <br />BUEHLER CARPENTRY CO /}~,~ <br />~9830 ECHO HILL RD /...~/~.~' <br />SClO. e7~74 ~ <br />PHONE: 85~-2558 <br /> <br /> ITEH <br />BUILDING FEE <br />PLAN REVIEW <br />BUILDING STATE SURCHARGE <br />ZONING SURCHARGE <br /> <br /> 9041490 <br />ARCHITECT/ENGINEER, HO. <br /> <br />PHONE: <br /> <br />QUANTITY <br /> <br />AMOUNT <br /> $62.50 <br /> $40.63 <br /> $~.~ <br /> <br /> TOTAL ASSESSED FEES $109.39 <br /> PREVIOUS RECEIPTS $0.00 <br /> THIS RECEIPT $109.59 <br /> BALANCE DUE $0.00 <br /> PAYEE: 8UEHLER CARPENTRY CO 45544 <br /> RECEIVEO BY: PW TYPE: CK CHECK ~: 5551 <br />· THIS IS NOT A PERMIT. YHI3 APPLICATION MUST 80 THROUGH A REVIEH PROCESS WHERE THE <br />FOLLO~IN~ MUST BE COMPLETED. IT IS THE RESPONSIBILITY OF THE APPLICANT TO ASSURE THAT <br />LL NECESSARY INFORMATION HASBEEN PROVIDED. <br /> <br />~ITY JURISDICTION: BY ...... D~TE ....... <br />~MARKG: DIN RM AOON <br /> <br />HEIeHT: iS SETBAOKS: FR_~_ <br />TOTAL 8Q FT: 160 L8 <br />STORIES: 1 RS <br />PLAN.ACTION: RR-~- <br />ENERGY PATH: <br /> <br /> OFFICE COPY <br />FORM # MC 15.58 REV. 4/9O <br /> <br /> <br />