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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG, NO. 225 <br />220 HIGH STREET NE <br /> SALPM, OREGON 97301 <br /> <br /> PHONE: 588-5147' 8:00 - 4:SO <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />The work will be performed by a registered builder. <br />Other <br /> <br />DATE: 11/16/92 TIME: 1S:13:37 <br />PIERCE, TOM & BETH <br /> <br />SITUS ADDRESS: <br /> <br /> 13047 MAPLE LEAF CT NE <br />AURORA OR 97002 <br /> <br />USE OF BUILDING. <br /> RESIDENTIAL ACCESSORY STRUCTURES <br /> <br />SAME ~ <br />PHONE: 678-1067 <br /> <br />SIGNATURE OP APPLICANT: <br /> <br />TAX LOT <br /> <br />CONSTRUCTION TYPE <br /> <br />~ CATEGORY; <br /> RESIDENTIAL <br /> <br />; OCCUPANCY: <br /> R-~ <br />;OCCUPANT LOAD~ <br /> <br />$UBO VISION: <br /> MAPLE LEAF ESTATES <br /> <br /> SITE NUHBER= 92-04026 <br /> VALUATION: $28,000.00 <br /> <br />LOT; <br /> <br /> 8 <br />WIDTH~ <br /> <br />105 <br /> <br /> SECTION; fOwNS~iI~: RANGEi : ZONE: ' MAP: <br /> 22 48 iW <br /> ~ IRREG. LOT: CORNER: <br /> AREA: ; UNIT :F <br />57O SSBSO. <br /> NO <br /> NO <br /> <br />NO OF BEDROOMS: <br /> <br />TYPE: BUILDING PERMIT OR APPLICATION NO: <br /> <br />CONTRACTOR, NO. 61572 <br />BILLY BLAND <br />5773 S. $CItNEIDER RD <br />WOODBURN, 97071-00~ <br />PHONE: 6~4-2240 .._~¢J_~ <br /> <br />PLAN REVIEW <br />8UILOING STATE SURCHARGE <br />ZONIM~ ~URCHAR~E <br /> <br /> 904~917 <br />ARCHITECT/ENSINEER, NO. <br /> <br />PHONE: <br /> <br />TOTAL ASSESSED FEES <br />PREVIOUS RECEIPTS <br />THIS RECEIPT <br /> <br />QUANTITY <br /> <br />AMOUNT <br /> $184.00 <br /> $119.60 <br /> $9.20 <br /> $9.20 <br /> <br />$522.00 <br /> $0,00 <br />$322.00 <br /> <br />BALANCE DUE $0.00 <br /> <br /> PAYEE: PIERCE, TOM & BEJf'W , 45988 <br /> RECEIVEO BY: MB ~_JL-.~- _, .... TYPE, CK CHECK ~: 2183 <br />* THIS IS NOT A PERMIT. THIS APPLICATION HUST GO THROUGH A REVIEW PROCESS WHERE THE <br />FOLLOWING HUST BE COHPLETEO. IT IS THE RESPONSIBILITY OF THE APPLICANT TO ASSURE THAT <br />LL NECESSARY INFORHATION HAS BEEN PROVIDED. <br /> <br />ZONING: BY ~ ...... DATE - <br /> DATE__~g~ STORIES; <br /> PLAN.ACTION: <br />CITY 3URISOIOTION: 8Y ........ QA~E ......... ENERGY PATH= <br />REMARKS: REMOOEL BATHROOM, 8EQROOM, LAUNO~Y ~ ANO AOOING ~/CAR 6AR <br /> <br />SETBACKS: FR ~-' <br /> RS_LO_ <br /> <br /> " OFFICE COPY <br />FORM # MC 15-56 REV. 4/90 <br /> <br /> <br />