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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 /> t ar'~ performing work on a property I own or occupy. <br /> i am a reSistered builder OR the authorized representative <br /> <br /> Other <br /> <br /> DATE: 10/05/93 TIME: 11:36:05 <br />OWNER~ DETROIT ELEMENTARY SCHOOL <br /> <br />SIGNATURE OF APPLICANT: <br /> DATE: <br /> <br />c~sr~l~.RC i AL <br /> <br /> 5-N <br /> 110 PAT'FON RD S- <br />DETROIT OR 97342 <br /> <br />O~U~ANCY <br />OCCUPANT <br /> <br />U~E OF ~ulLoi%~HQOL8 AN]Q gTHER' EI)UCA'TTONC;I~' ~OZ'I_B'r'i,IGS ....... <br /> <br />PO BOX ~ ' <br />~ETROIT~ O~ ~7~42 <br />PHONE: 854~6~ VALUATION: $40~800.00 <br /> <br />MAP; <br /> 105 <br /> <br />TYPE: BUILDING PERHIT OR APPLiCATiON HO: <br /> <br />CONTRAOTOR~ NO. 48256 <br />Nita Harris <br />10837 SE Mather Rd <br />Clmckamas~ 97015-92~i <br />PHONE: ~54-8949 <br /> <br /> ITEM <br />BUILDING FEE <br />PLAN REVIEW <br />BUILDING STATE SURCHARGE <br /> <br />PAYEE: Ni~a HarrJ. s <br /> <br />ARCHITECT/ENGINEER, NO. <br /> <br />PHONE: <br /> <br />TOTAL ASSESSEDFEES <br />PREVIOUS RECEIPT9 <br />THIS RECEIPT <br /> <br />QUANTITY <br /> <br />AMOUNT <br /> $242.50 <br /> $157.63 <br /> $12.13 <br /> <br />$412.2~ <br /> $8.80 <br />$412.2& <br /> <br />BALANCE CUE $0.00 <br /> <br />52854 <br /> <br /> RECEIVEB BY: PH TYPE: IN CHECK ~: 0 <br /> ................. ============================. ~ . ...... .._~.~.~_,~ ................................... ~ ~ <br />* THIS I$ NOT A PERNIT. THIsAPPLICATION HUST i;O THROUGH A REVIEW PROCESS ~HERE THE <br />FOLLO#ING NUST BE COHPLETEO. IT ISTHE :RESPONSZ~ILITYOF THE APPLICANT TO ASSURE THAT <br /> LL NECESSARY INFORNATZON HA~BEEN PROVIDED. <br /> <br />ZONING, BY. .-~/"-~"----' DATE r <br /> <br />CITY JURISBICTION: BY ......... DATE,, <br />REMARKS: REROOF - DETROIT ELEHENTARY SCHOOL <br /> <br />HEIGHT: SE'fBACKS: FR / <br />:TOTAL SQ FTc 0 LS"/ <br />STORIE~: RS'"/ <br />PLAN. ACTION: RR-/ <br />ENERGY PATH: SP~ .... <br /> <br /> OFFICE COPY <br />FORM # MS 15-5e REV, 4/90 <br /> <br /> <br />