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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: $88-5147 8:00 - 4:30 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />I am performing work on a property I own or occupy. <br />I arr~ 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 /> <br /> OATE: 12/07/92 TIME.; <br />OWNER: <br /> BLAZER INDUSTRIES <br /> <br /> 945 OLNE¥ <br />AUMSVILLE OR <br /> <br /> : 57806-000 COHMERCIAL <br /> <br /> 5-N B'"'2 <br />97S25 ' AUMSVILLE i NO r <br /> <br />iNOUSTRIAL BUILDINGS <br /> <br />SUBDIVISION: <br /> <br />PO BOX 5,55 <br />SILVERTON OR <br />PHONE: 749,~5962 <br /> <br />SITE NUMBER: 92-04192 <br />VALUATION: $97,45L.00 <br /> <br />LOT: <br /> <br />WIDTH: <br /> <br /> 2~ 8S 2W INO <br />460 445900~ SF NO : YES <br /> <br />TYPE: BUILDING PERMIT OR APPLICATION NO: <br /> <br />CONTRACTOR, NO. <br />BLAZER INDUSTRIES <br />PO 80X <br />SILVER'fON OR 97~81 <br />PHONE: 749-~962 <br /> <br /> ITEM <br />BUILDING FEE <br />PLAN REVIEW <br />BUILDING STATE SURCHARGE <br /> <br /> ~044272 <br />ARCHITECT/ENGINEER, NO.. <br /> <br />PMONE: <br /> <br />TOTAL ASSESSEO FEES <br />PREVIOUS RECEIPTS <br />THIS RECEIPT <br /> <br />QDANTI fY <br /> <br />ANOUNf <br /> $427.00 <br /> $277.55 <br /> <br />$725.90 <br /> $0,,00 <br />$725.90 <br /> <br />BALANCE OUE $O.OA <br /> <br /> PAYEE: BLAZER INDUSTRIES ~ 4642]. <br /> RECEIVED BY' MB ~ TYPE" IN CFECK ~- 0 <br />................. ~ .... 2~c~u~%'~%_~%%%~% ................... ~ ..................... ~ ........................... <br />* THIS is NOT A PERMIT. THIS APPLICATION MUST GO THROUGH A REVIEW PROCESS WHERE THE <br />FOLLOWING MUST BE COMPLETED. IT IS THE RESPONSIBILITY OF THE APPLICANT TO ASSURE THAT <br />LL NECESSARY INFORMATION HAS BEEN PROVIDED. <br /> <br />PLAN REVIEW: BY -~'--¢_~- DATE ~l~$/~'''~ BEIGHT: <br />ZONING: 8Y ............. DATE .............. TOTAL 8Q FT: 5848 <br /> <br /> PLAN.ACTION: <br />CITY JURISOIGTION: BY ................ OATE .......... ENERGY PATN: <br /> <br />REMARKS: LUNCH ROOM STORAGE AOON & OFFICE TO MANUFACTURING PLANT <br /> <br />SETBACKS: FR ............. <br /> LS ......... <br /> <br />OFFICE COPY <br /> <br /> <br />