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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG. NO. 225 <br />220 H~GH 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 on a property I own or occupy, <br />lam areglstered builder OR( ) the authorized representative <br />of a registered builder. <br />The work will be performed by a registered builder. <br />Other <br /> <br />I have read and agree to the terms stated on the reverse side <br />This document. <br /> <br />SIGNATURE OF APPLICANTz <br /> <br /> DATE: <br /> <br />OwNER:DATE: 01/14/93 <br /> HOERS, RAY <br /> <br />TIME: 13:17:10 <br /> <br />97342 <br /> <br />TAX LOT~ <br /> <br /> '90210-000 <br /> <br />DETROIT NO <br /> <br /> 320 DETROIT RD <br />DETROIT OR <br /> <br />SINGLE FAMILY DWELLINGS <br /> <br /> DEIROIT LAKE,SHORES <br />PO BOX 581 <br />DETROIT OR 97342 SITE NUMBER: 93-00179 <br />PHONE: 854-3201 VALUATION: $15,000.00 <br /> <br />138 266 36708_ SF NO NO <br /> <br />' CATEGORY: <br /> <br /> RESIDENTIAL <br /> OCCUPANCY; <br /> <br />TYPE: BUILDING PERHIT OR APPLICATION NO: <br /> <br />CONTRACTOR, NO. <br />HOERS, RAY <br />PO BOX 581 <br />OETROIT OR 97342 <br />PHONE: 854-3201 <br /> <br /> ITEM <br />BUILDING FEE <br />PLAN REVIEW <br />BUll. DING STATE SURCHARGE <br /> <br />ENERGY PATH: <br /> <br />REMARKS: ROOF OVER MOBILE HOME <br /> <br /> 44289 <br />ARCHITECT/ENGINEER, NO. <br /> <br />PHONE: <br /> <br />TOTAL ASSESSED FEES <br />PREVIOUS RECEIPTS <br />THIS RECEIPT <br /> <br />BALANCE DUE <br /> <br />QUANTITY AHOUNT <br /> <br /> $7i.83 <br /> $5.53 <br /> <br />$187.86 <br />$187.86 <br /> $o.oo <br /> <br />$0.00 <br /> <br /> PAYEE: <br /> RECEIVED BY: PB ...................................... TYPE: CHECK ~: 0 <br /> <br />* THIS IS A VALID PERHIT. THIS PERMIT EXPIRES 18o DAYS PROM ITS ISSBE DATE. IF <br />CONSTRUCTION CEASES FOR A PERIOD OF 180 DAYS, OR IF CONSTRUCTION FAILS TO NEET ALL <br />EQUIREHENTS OF STATE LAWS AND HARION COUNTY BUILDING ANO ZONING ORDINANCES, THIS PERMIT <br />SALL BECOME HULL AND VOID. <br /> <br /> HEIGHT: SETBACKS: FR 20 <br /> TOTAL SQ FT: 1848 LSd5 <br /> STORIES: 1 RS 5 <br /> PLAN.ACTION: RR~15 <br /> ENERGY PATH: SP ...... <br /> <br />DONALD E. WOOOLEY, MARION COUNTY BUILDING OFFICIAL / BY .......... <br /> <br /> ' OFFICECOPY <br />FORM # MC ~ 5-0e R~, 4/~0 <br /> <br /> <br />