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MARION COUNTY BUILDING iNSPECTION <br />SENATOR BLDG, NO. 225 <br />220 HIGH STREET NE <br /> SALEM, OREGQN 97301 <br /> <br /> PHONE: 588-5147 8:00 - 4:30 /"'1 <br /> 24 HOUR CODE-A-PHONE: 588-7904 // //~ <br /> ~ am performing work on a property I own or occupy, j / ~, . <br /> ~ ~ am a registered builder O~ the authorized repre~en a ire S ~NATURE OF APP~ CAN <br /> of a registered builder, ' ............... <br />~ T~¢ork will be pedormed ~y a regis,~r~d buil,er. ~"~ .... <br />( } I have rea~ ~n~ ~gree to the terms stated on the reverse rode o{ OA~; .................................. <br /> this document. <br /> <br /> 9ATE~ ~7/16/~ TINE: <br />'owN~,. ~"f~x ~6f,. .................. 0~f~6~9~ ..... <br /> HCLAUGHLAN~ ROBERT ~ RESIDENTIAL <br /> <br /> 1~67~ ~TAYTON RQ SE ~ .............. ,'Vi ......... 0~ ................. ===-===~='=. <br /> AUMSVILLE OR ~7325 ~ ~C~ouflTy ~ o~u .... ~u~, <br /> <br /> '0-~ d~ sO 'Lb'~ .......................................................................................................................... %x '~'~';~" <br /> SINGLE FAMILY 9WELLINGS ~ ~' <br /> <br /> SITE ~BEE~ <br /> PHONE: VALUATION: $8.8~ <br /> <br />~"~OT. ' .................. ~ BLoc'K: ~ ~E~TION'. ........ ?T~'~-~ ............. ~: .............. ~'~ ................. ~'~,. ............. <br />WIDTH: ~D[~H; AREA. ' ......... ~-8 ~S~ ............. ~"-- ~ ES~':- ........ 8D~E~': ............................ <br /> <br /> CONTRAOTOR~ NO. 86869~ ~ ~ ARCHITECT/EN~INEER~ NO. <br /> JmMes J Arnett Inc , ~/ ~ . <br /> ........ E I <br /> <br /> ~,,rJ~J~Mm.~ q I~-~R~ QIJAHTITY A~OUNT <br /> ........ ~' '~ ~ ' <br /> BUILBING STATE SURCHARGE <br /> ZONING SURCHARGE <br /> $8.58 <br /> <br /> TO~AL ASSES~EQ FEES $11. <br /> PREVIOUS. RECEIPTS <br /> THIS EECEIPT $11.8B <br /> BALANCE DUE <br /> PAYEE: JaM~ rnett I~c 5~797 <br /> REOEIVE9 TYPE: CE CHECK ~: 1826 <br /> ~ THIS PERHIT.~%THIS BI, HIT. ~XPZR~' 1~ DAYS FROH IT8 ISSUE DATE. <br /> CONSTRUCT[[ FOR~ A, ~RIOD OF/18G.D~Y~i OR .~ CONSTRUCTION FAZL~ TO HEET ALL <br /> E~UZREHEHTS OF STATE ~WS AND H~R~OH CO~Y BUZLD~HG BN~ ZON~HG ORD~N~HCES~ THZS <br /> <br /> REMARKS: BU/DEMO ' ~ <br /> <br />FORM # MC 1 ~-~Je REV, 4190 OFFICE COPY <br /> <br /> <br />