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MARION COUNTY BUILDING INSPECTION
<br /> S6NATOR BLDG, NO, 225
<br /> 220 HIGH STREET NE
<br /> SALEM, OREGON 97301
<br />
<br /> " PHONE: 588-5147 8:00 - 4:30 -.~ ............
<br />
<br /> · 24 HOUR CODE-A-PHONE: 588-7904 ~.~. ·,~,,,//~ ~~', %
<br /> ampe o m ngworkona pOperty}owr~ or OCCUPY
<br />~ I am a registered builder OR ( ) the authorized rep~:esentat,ve SIGNATURE OF APPLICAN~'/f~
<br />} ~o ~ registered builder,
<br />) The work wdl bo perfoT'med by e registered builder·
<br />
<br /> WII, I :[AM,r.~OI'I., ROBERT & let
<br />~ITUS ADDRESS
<br />
<br />CONSTRUCTION TYPE O ~1~/"%~t~f '~" :l Al'
<br />
<br /> CC NTRACT CITY: UGB O~,gr~ANT LOAD
<br /> 9687 CASF '~P -"
<br />AIIRORA qR 97~07_ ~AR O~ COUNTY
<br />
<br />MANUFA[;TURI~.'D STRUI':I URI:,:
<br />
<br />1.9S?.7 CASF.
<br />AIII-~OF:A, OR
<br /> HllNL. 678 ..~.~gR
<br />
<br />LOT BLOCH
<br />
<br />SITE NUHBER.- B3-80842
<br />VAL. UA'rl 9N~
<br />
<br />MAP'
<br />
<br /> c ::,[~. LOT:
<br />
<br />· Nfl
<br />
<br />TYPE: MANUFACTURED STRUCTURE
<br />r,,~ONT¥~Af;TO¥~ ~
<br />WILI...]'.AHSON~ ROBERT & ELIZABETH
<br />:1·9527 CASE RD
<br />AHRORA ~ ~R
<br />PHONE',: 478-5588'
<br />
<br />PERMIT OR APPLICATION NO:
<br />
<br />TO fAt_ A$SI;,,,,~.~EDFE, I~.,,~ .....
<br />PREVIO[,iE; RE :EIPT$
<br />THIS RECE;(PT
<br />
<br />BAI, ANCE DUE
<br />
<br />?045704
<br />
<br />QUANT l TY AHOLJN'/
<br />
<br /> $2r,4,.
<br /> $ '2 ,. ,I, 0
<br />
<br /> $0,, V,O
<br />$~:.'%.,, 10
<br />
<br />PAYEE: !,~lLL. 1;AM90N~ RO]3EF~T & ,F.I..;[ZABE~'H RE..,:t. ,I 1 4791,7
<br />F(FCEIVED BY: F'H 'lYF'E: CK CHELI~ ,1~., 3146
<br />
<br /> THIS I~ NOT A PERHIT. THIO ~PPLIC~TION MUST ~0 THROUGH A REVIEW PROCESS WHERE THE
<br />FOLLOWING HUST BE COHPLETED. IT IS THE RESPONSIBILITY OF THE APPLICANT TO ASSURE
<br />THA~ ALL NECESSARY INFOE~ATIQN HAS BEEN PRQVI~EB.
<br />
<br />Pl.,ANN I NI;- ACTION: ~
<br /> zo~,m,m ~¥ ~ -z-/''-~ ........... !~.A'l'~("'2 ;'2.Zi~-~ii~i=:.'i;
<br /> Sl.':'F"~zCr~ ~V:' ....;7,~;.ZZ;7.'.'".:'.;. CA~'FC;;~;%4.~_~.~ ....
<br /> C]:TY:' JHR:rSI TCI]'ON: BY PATE
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<br />O~FICE COPY
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