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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: 688-7904 <br /> <br />I ~rn performing WOrk on a property I own or occupy. <br />I am a registered builder OR the authorized representative <br /> of a registered builder. <br />The work wilr be pedormed by a registered builder, <br />Other <br />I have read end agree to the terms stated on the reverse side of <br />this document. <br /> <br />DATE: <br /> <br />;TAX LOT: , <br />~ F'AULKIqER,, HAM, tN i RE'r~]:DI:N'!"',[AL <br /> SITUS ADDRESS'. CONSTRUCTION TYPE: i ~dOPA~dYl <br /> <br /> AI,/HSV:i:LLiii; i'.Ji:~ 973:;!5 i HAR]:ON COUNTY', N0 <br /> UrE OF BUILD~G; ................... ~NO: d~ e~ORO0~ <br /> <br /> SITE NUMBER: 93-81987 <br /> F'HONE: 58:P-,OiL44 ~ VALUATION: $2',L~ 6~8. ~8 : <br /> <br /> ~ _ : !~ ~ es ~ 2u ~F ' 49 <br />WIDTH: DEPTH; ' ARE~: ]-T¢~';-~f; ............... ]r68~'~~ <br /> 1,, 35 AC NO ] NO <br /> <br />TYPE: BUILDING <br /> <br />CONTRAC'f'OR,¢ <br />FAtJt,, KN EiI:~,~ NAJ::W <br />SAHE <br /> <br />PERHIT OR APPLICATION ilO: <br /> <br /> ~;'B47642 <br /> <br />ARCH <br /> <br />F'HON,E; 58:1,.-,0144 PHONE: <br /> <br /> ITEH <br />BL~IL, I) ];HG FEE <br />PLAN REV I E'N <br />BLJ;I'LI)INC~ STATE SURCHARGE <br />ZOFI:r NG SURCHAR6F' <br /> <br />NO, <br /> <br />TOTAL ASSESSED FEES <br />PRE\ ].BUS RECEIPFo <br />Ti-!IS RECEIPT <br /> <br />QUAN'f'ITY <br /> <br />AHf]UNT <br /> $152.50 <br /> $9,0,, J. 3 <br /> $7.63 <br /> $7.63 <br /> <br /> $266.8,° <br /> <br />BALANCE ))UP $~,, 0,';~ <br /> <br /> I,,A.,Y,F.,,, I~AUL. IkIIER.~ ~ARs~h 49935 <br /> <br />$ THIS IS NOT A PERNIT. THiS APPLICAtiON HUST GO THROUGH A REVIEW PROCESS WHERE THE <br />FOLLOWiH6 M~ST BE CO~PLETE9~ tT iS THE EESPQNSIBILITY 8F THE APPLICANT ~O ASSURE THAT <br /> LL NECESSARY INFORHATION HAS BEEN PROV~DEB. <br /> <br />HEI GltT," 10 SETBACKS= FR <br />TOTAL 8f~ FT: 2400 L.S"' <br />STORIES: i R S'"-7'"" <br />PL, AN. ACTION: ,,/ ~ <br />ENERGY PATH:', /~ /~' SP._] ....... <br /> <br />¢on~ ~ MC ~5-5~ ney, 4~o OFFICE COPY <br /> <br /> <br />