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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: 58847904 <br /> <br />I am a registered builder OR the authorized representative <br />of a registered builder, <br />The work will be performed by a registered builder. <br />Other_ <br /> <br /> this documenf. <br /> I)ATIii:: :[1129193 'T'I'MF:, :10254:',04 <br /> <br /> AU~SV :(LLE OR 97S2S <br />O~OF ACCESSORY STRUCTURES <br /> <br />OUPANT LOAD: <br /> <br />NO OF BEOROOMS' <br /> <br />MAILING AODRE$$: SUGOIVISION; <br /> <br />SAME ~ <br />PHONE: '749-,,2S45 ~ <br /> <br />TYPE: BOiLDtNG <br /> <br />PERMIT OR APPLICATION <br /> <br />CON FRAC i" OR,~ NO. 47650 <br /> <br />,,,.1,,.) Dawn Pl. ace <br />Sub 1J.~ii'z~ 77~85-0000 <br />PHONE: 7&9-642~ <br /> <br /> 91i~51§5~ <br />ARCNITECT/ENGIMEE'I% <br /> <br /> ITEM <br />BUILDI'N6 FEE <br />Pl. AN I'~EV;£ EW <br />BU~LDIN(; STATE SUROHARg, E <br />ZONING SIJRCHAEGI;~ <br /> <br />F'HONE: <br /> <br />QUANTITY <br /> <br />AMOUN'f' <br /> $74.58 <br /> $48.47 <br /> <br /> $;%7,7 <br /> <br />: TO'I'~L D F <br /> <br /> ': :PREVIOUS RECEIPTS: $0. <br /> <br /> $0 <br /> 00 <br /> FAYEE: HAROLD SMITH : :. '53999 <br /> RECEIVED BY". D~2 i,~v TYFE': OK C~'"]K 4]~' <br /> $ THIS IS NOT A PERMIt. REVIEW PROCESS WHERE THE <br />FOLLD~IN6 ~UST BE YHE APPLICANT TO ASSURE ~HAT <br /> LL NECESSARY INFORMATION HAS:;BEEH ~RO~IDED. <br /> <br /> SEFTZC~ ~Y-.Z .......... 1 <br /> C:[TY ,.IU~]:SDICTD:ON: BY ................DATE ........................ ENERGY PATH: <br /> <br />FORM # MC 1 ,I-56 REV. 4,'90 <br /> <br />OE COPY <br /> <br /> <br />