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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: 598-5147 8:00 - 4:30 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br /> KLINE.,- HAR¥IN <br />i SITUS ADDRESS; i CONSTRUCTION TYPE; [, OCCUPANCY; <br /> 107¥4 HILl._ CREEK RD ..... OONTRAOT CITY'. '. ~OCCUPANT LOAD: <br /> AU~SV,(L,LE OR 97325 <br /> <br />USE OF 8UtLOING: <br /> <br /> F'd[NE: 747.,,,21&S VALUATION: $35~ e88.08 <br /> ' 8LOCK , SECT ON'. TOWNSH P'. ~ RANGE; ~ ZONE MAP <br /> <br />TYPE: BUILDINE PERMIT OR APPLICATION NO: <br /> <br />CONTRACTOR, N0., <br />KLINE,~ MARVIN W <br /> <br />36;~-6289 -- WOFd< <br />PHONE:: 74~-2168 <br /> <br />~¢UtLDIN~; FEE <br />PLAN REVIEW <br />BUILDIN6 STATE SUF<CHARGE <br />ZONING SURCHAI:~CE <br /> <br />F'AYE~tl GLENN B ZICCARDT <br /> <br /> ~847578 <br /> <br />ARCHI TECI'/EN61NEI~£f% NO. <br /> <br />PHONE.. <br /> <br />TOTAL ASSESSED FEES <br />F'REVIOUS RECEIPTS <br />THIS RECEIPT <br />BALANC~ DUE <br /> <br />QUAN'F:["i'¥ <br /> <br />AMOUNT <br /> $215.50 <br /> $140.08 <br /> $10,,78 <br /> $10.78 <br /> <br />$~77.14 <br /> $0.~ <br />$377.14 <br /> <br />$0.00 <br /> <br />4~844 <br /> <br /> RECEIYEI) BY~ PM TYPE: CE CHECK ~:: 1208 <br /> ~ THIS IS NOT A PERMIT. THIS APPLICATION HOST GO THROUGH A REVIEW PROCESS WHERE <br />FOLLOWING MUST BE CO~fPLETED. IT IS THE RESPONSIBILITY OF THE APPLIOANT <br /> LL NECESSARY INFORMATION HAS BEEN PROVIDED. <br /> <br />HEIGHT: ,,, SETBACKS: FR <br />TOTAL SQ FT: 1000 ~S'"'~ .... <br />STORIES: 1{. <br />F'L~. ACT~0N: R~ <br />ENERGY PATH: 1 SF ........ <br /> <br />PLAN REVIEW',: B_LY~,z_~.C DATE <br />SEl:"r:~: t?, ~Yt:~;%'.%T,:;',%72':7'.'Z',: DA <br />CITY JUR:I;SDICTION; BY ........................... DATE ........................... <br /> <br />FORM # MC 18,1~6 REV. 4/90 OFFICE COPY <br /> <br /> <br />