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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: 588-5147 8:00 - 4:80 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br /> f am perform~r]g work on a property f owr~ of Occupy. <br /> I arrl a registered builder OR the authorized representative <br /> of a registered builder, <br /> The work will be performed by a regi~tePed builder. <br /> Other <br /> <br />DATE: 02/0~5/91 'l'ilVtE: 11:29:57 <br /> S'f'UBBL.¢F i ELD, <br /> <br />AU~Vi LLE OR 97325 <br /> <br />AUfqSVI LLE <br /> <br />90010-220 CO¢41~1ERC,( AL <br /> NO <br /> <br />'No O~'~£DROOMS: <br /> <br /> RES'f 'AU RAN'f <br />MAIL~NG ADDRESS: <br /> <br />5253 ¢,~ADRC,'NA HEJG'iHi"S DR <br />SJ, LVER1GN, OR 97381 <br />PHONE; 873-6616 <br /> <br />?500. <br /> <br />AUIv~vI LLE ADDiTiON <br /> <br />51 ¥'E NUfVlBER-_ t2237 <br />VALUATION: $105,000.00 <br /> <br /> 2~ C <br /> NO , YES <br /> <br />'fYPE: 8UiLOI. NG PERff~IT OR APPLICATION NO: <br /> <br />CON'I'RAC'I'OR. NO. <br /> <br />5263 ~AORONA HEIGHi'5 OR <br />SiLVER'rON, OR 97381 <br />PHONE: 873~6615 <br /> <br />BUILDING FEE <br />PLAN REVIEW <br />BUILOiN~ STATE ~URCHARGE <br /> <br /> 9030210 <br />ARCHi'T'EC'I'/ENGiNEER, NO. <br /> <br />PHONE: <br /> <br />TOTAL A,'S~E~.%'ED <br />PR~¥IOUS RECEIPT8 <br />THIS RECEIPT <br /> <br />QUAN'f'iTY <br /> <br />.A.~'gUNI <br /> ~445.50 <br /> 289.58 <br /> $22-28 <br /> <br />$?57.35 <br /> $0.00 <br />$?5?. 36 <br /> <br />BALANCE DUE $0.00 <br /> <br /> PAYEE: S'f'UBBLEFiEL(~,.cRON 21926 <br /> RECEIVED BY: PR .~FC_..,/ TYPE: IN CHECK ~: 0 <br /> <br />~ FHIS IS NOT A P~ZT. 'THIS APPLI~'TZ~ ~'T G~ 'FH~GH A REV.[EN PR~ESS ~ER~ 'fME <br />FOLL~iNG NUST BE ~PL~T~O. iT I~ 'FH~ R~81~iLI'FY OF 'FH~ APPLICANT TO A~RE THAI' <br />ALL N~C~ARY INFO~Ti~ HAS BE~N P~ViD~D. <br /> <br />SEPTIC: 8Y BATE <br /> <br />ZONING: BY DA'T'E SE'I'BACK~: <br />R~Jv~RKS; R~0EE""&'"'REPA]R'"'TA~E~ .... <br /> <br />HEiGHI'~ 'TOTAL ~ F'I': 4300 <br /> <br />HEALTH OEP'T: BY OA'IE <br />CiTY JUR1~B~C'1'1ON: BY .............................. 0ATE <br /> <br />STORIES.* <br /> <br />LS RS RR ~P <br /> <br />PLAN.AC'I'iON: <br /> <br />FORM # MC 15-56 R~V, 4/90 OFFICE COPY <br /> <br /> <br />