|
MARION COUNTY BUILDING INSPECTION
<br /> SENATOR SLOG, 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 />I am a registered Duild~¢ OR the ~uthoDzed representative SIGNATURE OF APPLICANT._.
<br />loP-;n; ~t;iftfr~,:,tb~;rdke;>n, a property , own or oooups. ~ I
<br />The work will be performed by a registered builder.
<br />Other
<br />I have read and agree fo fhe terms stated on the reverse side of DATE:,
<br />
<br />OWNEn: DATF::
<br /> 1..A)~D t E SNO;ODE;RL,¥
<br />SITUS ADDRESS:
<br />
<br /> AURORA
<br />USE OF BUILDING'.
<br />
<br />¢d5/28793 T~;NE: !6:89:24 tXX L6'r:
<br /> CONSTRUCTION TYPE:
<br />
<br /> OT'TAWAY RD NE CONTRACT CITY: MOB:
<br /> OR 978~2 HARZON "" ' ~"
<br />
<br />RE'S I DI~,: qT::AL,
<br /> LOAD:
<br />
<br />SUBDIVISION;
<br />
<br />LOT:
<br />
<br />WROTH:
<br />
<br />F'O BOX 364
<br />AURORA,, OF~ M0~iLE,,,,TS4-:LOEC,) SZTE NUi"~BER: 9;~-~1862
<br />PHONE: '"
<br /> ,~b
<br />
<br />TYPE: BLIILJDIN6 PERMIT OR APPLICATION NO: 9t~474BS
<br />
<br />AR£,HI1ECF, LIiG,I. IIEL~% NO,,
<br />F I-I0 NF'.
<br />
<br /> I Ti.'-] H QUAN'f']: 'f'Y AMOUNT
<br />OTHER ZI*tSPECTI(:)NS $40,, 00
<br />
<br />TOTAl,, A~>SESoED FEES
<br />PREVi/:JUS I~ECE}:PTS
<br />THIS RECEYPT
<br />
<br />$40.00
<br />$8,.00
<br />$40.00
<br />
<br /> BALANCE DUE $0.00
<br /> F'nYEE: I,.SD~IE BNO~DERLY ~'
<br /> 4967'7
<br />,,, !! E ~ E .~ ~ ~ ~_ ~ ~ ~. _. ~ ~ ~ = = ::,: = = ~ =: .=: = = .: ,:,. ,,,, :: =, ....~__ =: =: = = = = = = ,= = ................. ~?:_.!E___.!!?'J!!i~!! .,%.__!:~!~ ...................
<br /> * THIS IS NOT A PERMIT. THIS APPLICATION MLlST GO THROUGH A REVIEW PROCESS WHERE THE
<br />F¢LLOWIHG MUST BE COMPLETE~. IT IS THE RESPONSIBILITY OF THE APPLICANT T~ ASSORE THAT
<br />LL NECESSARY INFORMATION HAS BEEN PROVIDED,
<br />
<br />PL. AN REV:I:I,z:m~ BY ~ 9A'FE ~,-~.'~,~,,.~ HEIGHT:
<br />ZOI,IZNC: BY .............................. ~TE .......................... TB'f~L S8 FT~
<br />
<br />CITY ,JUR:[SglCTION~ ~Y. ....................... D~'TE ............................... ENERGY
<br />
<br />REMARKS: REV]:SED F'LANS -- ADDING MORE iNSULATI:DN
<br />
<br /> SETBACKS: F'R ~
<br />0 ._] .......
<br /> RS .............
<br /> RR
<br />
<br />FORM ~ MC ~5 ~f REV, 4/90 OFFICE COPY
<br />
<br />
<br />
|