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MARION COUNTY BUILDING INSPECTION <br /> SENATOR BLDG. NO. 225 <br /> 220 HIGH STREET NE <br /> <br /> PHONE. 588-5147 8:00- 4:30 / <br /> 24 HOUR CODE-A-PHONE: 588-7904 <br /> <br /> I 8m performing work on a property I own or ~upy. <br /> I am a registered builder OR the authorized rerresentatlve SIGNATURS OF APPLICANT:...../~--~ <br /> Other_°faregisteredbullder' <br /> The work will be performed by a registered builder, <br /> <br /> D~TE: 01/25/95 TIH~: <br />¢ ~N~ TAX LOT ~ CATEGORY'. <br /> GREEN, JOE 70551~501 ~ RESIDENTIAL <br /> <br />: ~749 ~RBLER L~NE NE ~ CONTRACT CITY: ', U~B: ~OCCUPANT LOAD: <br /> ~URORA OR 97002 , HARZON 60UNTY', <br />USE OF ~UI~DING; <br /> RES[OENT[~L ~OCESSORY STRUCTURES <br />~ MAIL~NG ADDRESS; <br /> <br /> ~ CENTURY HEADOWS <br /> P0 BOX 759 ............................ <br /> PORTLAND, OR 97207 8~TE NUMBER: 9~-00299 <br /> PHONE: &85-S&85 ~ V~LU~T[ON: <br /> <br /> BLOCK; : SECTION: : TOWNSHIP; I ~ ~'~E~ <br /> <br />8 <br /> <br /> 20 [ 33 3S I 1W AR 1 <br /> <br /> 100, 6500. SF j NO i NO <br />65j ~ <br /> <br />TYPE: BUILDING PEEHIT OR APPLICATION NO: <br /> <br />CONTRACTOR, NO. 57652 <br />JOE GREEN INVESTMENT CO <br />P 0 BOX 759 <br />PORTLAND, 97207-000 <br />PHONE: 685-9685 <br /> <br /> 9044986 <br />ARCHITECT/ENGINEER, NO. <br /> <br />PHONE: <br /> <br /> ITEM QUANTITY AMOUNT <br />BUILDING FEE $17.50 <br />PLAN REVIEW $11.$8 <br />BUILDING STATE SURCHARGE $0.88 <br />ZONING SURCHARGE $0.88 <br /> <br />TOTAL ASSESSED FEES <br />PREVIOUS RECEIPTS <br />THIS,RECEIPT <br /> <br />$30,64 <br /> $0.00 <br />$50.64 <br /> <br />BALANCE DUE $0.00 <br /> <br /> PAYEE: JOE GREEN .I,-,NYE~z~F~IENT.CO . 47141 <br /> RECEIVED DY: MBJL~' ~ ' . .... TYPE: CK CHECK ~I 1342 <br />* THIS IS NOT A PERMIT. THIS APPLICATIO~ MUST GO THROUGH A REVIEW PROCESS WHERE THE <br />FOLLOWING MUST BE COMPLETED. IT IS THE RESPONSIBILITY OF THE GPPLICANT TO ASSURE THaT <br />LL NECESSRRY INFORMATION HAS 8EENPRO¥IDEO. <br /> <br />ZONING~ 8y~:¢~ OATE.~2~i~i <br />SEPTIC: BY ...... ZiZZZiZi] DATE <br />CITY JURISDICTION: BY ........ DATE <br />REMARKS: CARPORT <br /> <br />HEIGHT: 9 SETBACKS: LS"'~ <br />TOTAL SQ FT: 200 <br />STORIES: RS]'2/~]]~ <br />PLAN.ACIlON: RR ~ <br />ENERGY PATH: SPZ_]]] <br /> <br />OFFICE COPY <br /> <br /> <br />