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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 - 4:3,0 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />I am per ormlng WOrk on a property I owe or occupy. <br />lam a registered bt. dlderOR( )theauthorizedrepreser/tative <br />of a registered budder. <br />The work will be performed by a registered builder. <br />Other <br /> <br />I)A I'E',~ 02123173 <br /> <br />M I T(L:M;~I,. I.. ,¢ TODD <br /> <br />248 YEW 6'r <br /> <br /> TAX LOT: <br /> 57706-¢W~0 <br /> ' CONSTRUCTION TYPE <br /> <br /> 28 CONTRACT CITY. UGB; <br />OR ~)7325 AUHSVILLE <br /> <br />USE OF BUILDING. <br /> Id.SII~EI4'flAL ALCiL~SORY STRWCTLIRES' <br /> <br />41817 K]:I,I[;STON L, YOWB <br />g'fAYTON OR 97383 <br />F'HONEB 769-456'," <br /> <br />CVERgREEN HH PARK <br /> <br /> SITE NUMBER: <br /> VAL UAI'ION:I <br /> <br />LOT: BLOCK: SECTION TOWNSHIP <br />WIDTkh D[~) DEPTH. (~6 AREA ~,¢.~,I0 ~ J NITS: <br /> <br />CATEGORY <br /> RES 1DF]~I1 IAL <br />OCCUPANCY: <br /> <br /> H-,.:L <br />OCCUPANT LOAD: <br /> <br />9~-o87e2 <br /> $2~600.00 <br /> <br />2W RM <br />H/I <br /> <br />NO OF BEDROOMS <br /> <br />TYPE: BUILDING PERMIT OR APPLICATION NO: <br /> <br />CONI RFIO FCIR,, N(,1. <br />MITCHELL.. TODD <br />41817 IC[N(,;!~TON LYONS 9R <br />STAYTON 9R 97~83 <br />PHONE~'. 769'.. 4565 <br /> <br /> ]:TEN <br />BUII. DIN[; FEE <br />PI. AN REVIEW <br />BUILI):[N(;, STATE SLIRCHARf;E <br /> <br /> 91tl4S49~ <br /> <br />ARCHI TEc'r/EN/; I NEEI~,~ NO.. <br /> <br />PHONE,*, <br /> <br />TOTAL A$.SESSE:I) FEE'S <br />PREVIOU!~ RI,:L'CEi I PTS <br />'THIS REbEIPT <br /> <br />QUANTITY <br /> <br />AHOLINT <br /> $38,.50 <br /> $25.83 <br /> $1.93 <br /> <br />$65,46 <br /> $0.60 <br />$6,¢.46 <br /> <br /> J~AL.AI,IC[; DUI.;: $0.00 <br /> PAYEE~ MITCHELl.,, ft',ll)I) ~{0 , ,. 4'7714 <br /> <br />FBLLO~[H6 HUST ~E COflPLETE~. IT ZS THE RESP~HSZ~LZTY OF THE APPLICANT TO A~SURE THaT <br /> <br />ZON N ;B ....... ATE <br />Sf:.PT I Ch~ })~Y ......... ~:::::,:.',:: ....... DATE ....................... <br />,1fY ,.I(IRISD:I:CT]:ON~ ~Y .................. :OATE ................. <br />REH6RKS:: CARPON'f <br /> <br />HEIGHT: 10 SEFI)ACK8,~ FR :D~) <br />TOTAL SO F T. 26~ LB-/ <br /> <br />P LAN. Ab T l ON: t~'-' :t ~ <br />ENERGY PATH: S F".:j ........ <br /> <br /> OFFICE COPY <br />FORM # MC 15-56 REV. 4/9o <br /> <br /> <br />