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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG, NO. 225 <br />220 HIGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br /> I am performing work on a property I own or occupy. <br /> I am a reslsterod builder OR ) tho authorized representative <br /> of a registered builder, <br /> The work will be performed by a reg}stered builder. <br /> Other ....... <br /> I have read and agree to the terms stated on the reverse side of <br /> this document. <br /> <br /> DATE: 07/24/92 T:~HE: 1~:51:04 <br />OWNER; <br /> ARESTAD, BRUCE <br /> <br /> PHONE: 588-5147 8:00 - 4:30 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br /> DATE; <br /> <br /> 15102 ARNDT ROAD NE <br />AURORA OR 97002 <br /> <br />fAX LOT' <br /> <br />CONSTRUCTION TYPE'. <br /> <br />~ C~TGu N T V <br /> <br /> E~DENTIAL <br />OCCUPANCY'. <br /> <br />occup£~'f ~ <br /> <br />USE OF BUlLD~,~NER NON-RESIDENTIAL BUILDINGS <br /> <br />MAIklNG ADDREss; SUBDIVISION <br /> <br /> 8AHE ~ ............ <br /> BITE NUMBER: <br /> PHONE: 678-5158 ,_..,,... VALUATION: $4.000.00 <br /> <br />~r 'F BEDROOMS <br /> <br />LOT. BLOCK SECTION: TOWNSHIP RANGE ZONE MAP' <br /> ~ 48 ZW EFU <br />,WlOTH: DEPTH AREA: 28. U NITt~;C I1~'~ LOT <br /> <br />TYPE: BUILOIN6 PERMIT OR APPLICATION NO: <br /> <br /> 9041499 <br /> <br />CONTRACTOR, NO. ARCHITECT/ENGINEER, NO. <br />ARESTAD, BRUCE <br />SANE <br /> <br />PHONE: 678-5158 PHONE: <br /> <br /> ITEH QUANTITY ANOUNT <br />BUILDING FEE $44.50 <br />PLAN REVIEW <br />BUILDING STATE SURCHARGE $2.23 <br /> <br />TOTAL ASSESSED FEES <br />PREVIOUS RECEIPTS <br />THIS RECEIPT <br /> <br />$75.66 <br /> $0.o0 <br />$75.66 <br /> <br />BALANCE DUE $0.00 <br /> <br /> PAYEE: ARESTAO, BEUCEt/'% 4~552 <br /> RECEIVED BY= NB_%.~/~_c&4 ..... TYPE: CK CHECK B: ~889 <br /> <br />FOLLOWIN8 ~OST 8E COMPLETED. IT IS T~E RESPONSIBiLiTY OF TME APPL~OANT TO ASSURE THAT <br />LL NECESSARY INFORMATION ~AS BEEN PRO¥IOEO. <br /> <br />PLAN <br /> <br />SEPTIC: BY .... ~.~.__ DATE ............ STORIES: <br /> PLAN.ACTION: <br />CITY JURISDICTION: BY ........ DATE ......... ENERGY PATH: <br /> <br />REHARKS: POLE PARTITIONING IN A POLE BLOG AND A BATH <br /> <br />BETBACKS: FR <br /> <br /> R R__-~-__ <br /> SP <br /> <br />OFFICE COPY <br /> <br /> <br />