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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG. NO. 925 <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 am a registered builder OR the authorized epresen ave <br />The work will be performed by a registered builder, <br /> <br />SIGNATURE OF APPLICANT: <br /> DATE~ <br /> <br /> 12173 WEST STAYTON RD SE <br /> NO, OF BEDROOMS <br /> <br />SAME <br /> <br />PHONE: 769-7586 <br /> <br />TYPE: BUILDING <br /> <br />CONTRACTORE NO. <br />WELLS, JEFFERY <br />SAME <br /> <br />PHONE= 76~-7~06 <br /> <br />PERMIT OR APPLICATIOH MO: 48553 <br /> <br /> ARCHITECT/ENGINEER~ NO. <br /> <br /> ITEM <br />BUILDING FEE <br />PLAN REVIEW <br />BUILDING STATE SURCHARGE <br />ZONING SURCHARGE <br /> <br />PAYEE= <br /> <br />PHONE: <br /> <br />TO.TAEA~.~SSED, FEES <br />PREVIOUS ~ECEiPTS <br />THIS'RECEIPT <br />BALANCE DUE <br /> <br />QUANTITY <br /> <br />AMOUNT <br /> $80.50 <br /> $52.33 <br /> $4.03 <br /> $4.05 <br /> <br />$140.89 <br />$1.40.89 <br /> $0.00 <br /> <br />$0.00 <br /> <br /> RECEIVED BY: PB TYPE: CHECK ~: 0 <br /> ................ :::-_======_-=-==: _ -- -===~.. <br />C_~_[~_[~. A_~A~ID PE~IT.,,'THIS,~RHIT,,'EXPIRES 18a DAYS FROM ITS iSSUE DATE. IF <br />UN~/NUCTIUN CEASES FO~'A' pERtOD',OF'lDBDAYS~'OE IF CONSTRUCTION RAILS TO MEET ALL <br />EOU~REMENTS OF STATE [~Ak~ AM9 MAR~ON COUNt,DUkEDOM& AND ZONING ORDIMAMCES~ THIS PERH~T <br /> ALL BECOME HULL AND VOID~ , <br /> <br />ENERGY PATH: <br /> <br />REMARKS.~ GARAGE AND ROOF ALTERATION <br /> <br />::TOTAL SQ FT: <br />STORIES: 1 <br />PLAN~ACTION: <br />ENERGY PATH: <br /> <br />DONALD E. WOODL. EY~ NARION'c:0UNT'Y BUILDING 0FFi:CiAL / By <br /> <br />OFFICE COPY <br /> <br />728 <br /> <br />SETBACKS: FR / <br /> L8-10 <br /> RS"IO <br /> ER-30 <br /> <br /> <br />