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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 />Other <br /> <br />SIGNATURE Of APPLICANT: <br /> <br /> DATE: 1.~/.0~/9.2 TINE: 8:39:42 <br />OWNER: <br /> SIMPSON, GREG I 57706-000 ' RESZDENTZA[,, <br /> <br /> [ 5--H ; H-.i <br /> ~5.5 EVERGREEN OR <br /> ~UHSVZLLE OR 97525 j ~UHSVZLLE NO LOAD: <br /> <br /> RESIDENTIal RCCESSORY STRUCTURES <br /> <br /> ~ S[TE HUHBEE: 92-04~76 <br /> e~ddR - SECTION ~ , <br /> <br />L . 100 ~ 3F ~ YES YES <br /> <br />TYPE: BUILDING PERHiT OR APPLICATION NO= 9044247 <br />CONTRACTOR, NO, ARCHiTECT/ENGINEER. <br /> <br />PHONE: 8'?"9~Z¢2~2~ PHONE: <br /> ITEH <br />BUILD[NQ FEE <br />PLAN REVIE~ <br />BUILDING STATE SURCHARGE <br /> <br /> PAYEE: $IMP~ON, GREG <br /> RECEIVED BY. PB <br />z THIS I$ NOT A PERMIt. <br />FOLLOWING HUST BECONPEE' <br />LL NECESSARY ~NFORHA~ <br /> <br />:::"TOTAL ASSESSED ;FEES <br /> <br /> QUANTITY ~.~D AMOUNT <br /> $44.50~£~ <br /> $28.95~,~ <br /> <br /> $75.66~2~ <br /> $0.00 <br /> $7.5.6~ <br /> <br /> $0.00 <br /> <br /> 46596 <br /> TYPE: IN CNECK ~: 0 <br /> <br />~ REVIEW PRO6E$$ WHEre THE <br />THE APPL]OANT TO ASSURE <br /> <br />PLAN REVIEW: BY :ii <br />ZONZNG: BY <br />SEPTIC: <br />C TY UR SOZCTION: ENERGY PATH= <br />REHARKS: C~RPORT <br /> <br />SETBACKS: <br /> <br />FR 10 <br />L,S-6 <br /> sZ/ <br />RR_~O <br />S P ...... <br /> <br />FORM # MC 1~.~ RSV, 4/~0 OFFICE COPY <br /> <br /> <br />