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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:.30 <br />24 HOUR CODE.A-PHONE: 588-7904 <br /> <br /> The work will be per[ormed by a registered builder, <br /> Other <br /> <br />[ 5~h7 ...... <br /> ,,IACOBE~ KEN 57799-~0~ RESII)EIqT IAI_, <br /> <br /> ~-N <br /> 6~50LNEY ST <br /> <br />~ ~ ~mO~ ~ --~ .............................................................................................................. <br /> SINGLE FAMILY DWELL'.[NGS <br /> <br /> SALEH~ OR~'"' 973¢! ~ SITE HUMBER: 93-82282 <br /> PHONE: 762-788~ ~ VALUATION: <br /> <br /> ................... ~L~[; ~'~dt~5~; .......... T~5~; ..... ~E~i ..............7b~i ........... ~ .................... <br /> <br /> TYPE= ~ELL~N~ PER~IT OR ~PPLiCATION NOa ~8~8 DP <br /> <br /> CONTRAC;TOR~ NO,, ARCH~TECT/ENGINE~;~ NO. <br /> JACOBE. KEN <br /> 441~ HONROE AVE NE <br /> <br />SALEM, OF( 97~81 <br />PHONE: 3~2-7888 <br /> <br />DWELLING BUILDING FEE: <br />DWELLING PLUMBING ,'; <br />DWELLING HECHANICAL I: <br />DWELLING ELEC'fF<~CAL <br />DWELLING STATE SURCHA <br />DWELLING PLAN REVIEW <br /> <br />QUANTITY AMOUNT <br /> $239.42 <br /> <br /> $21.75 <br /> <br /> $~22.47 <br /> $622.47 <br /> <br /> PAYEE: JACOBE,. KEN <br /> RECEIVED BY: gL <br /> <br /> * THiS IS NOT A PERttI <br />FOLLOWING ffUST BE <br /> LL NECESSARY <br /> <br /> PI. AN REVIEW: BY <br /> ZONING: ~Y FT= <br /> SEPTIC: [~Y '? ES'~ [ <br /> ION: <br /> ENERGY ~A b. 1 <br /> C I T Y ,JUR I S D :[ CT I ON: B Y.2] I 1~:' ' <br /> <br />TYF'E: IN <br /> <br />1488 <br /> <br /> 50288 <br />CHECK ~: 8 <br /> <br />SETBACKS: <br /> <br />FR <br /> <br />SF'"L]..,.Z <br /> <br />FORM # MG 15-~ REV, 4/90 OFFICE COPY <br /> <br /> <br />