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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 /> I am performing work on a property I o~vn or odcupy. <br /> I am a registered builder OR the authorized representative SIGNATURE OF APPLICANT: <br /> of · registered builder. <br /> The work will be pedormed by a registered builder. <br /> Otl~er <br /> I have read and agree to the terms stated on the reverse side of OATE; ................................................ <br /> this document, <br /> <br /> :BATE.~' '~:i-/25/94 TIME: 12: <br />~'~; KLEIN, IRENE ~ JERRY ~ 67~44-~14~-Z~ '[ REStDENTIgL <br /> <br /> 72~2 SMITH RD SE <br /> AUMSVILLE : OR ?7325 M~RI'~ ~OUNTY [ ~' ~ ' <br />~[ 5~[~'~ ~T~: ................................................... [ ~ [NO O~ aEO,OOMS: <br /> RESIDENTIAL ACCESSORY STRUCTURES / <br /> <br /> ...... ~___~.~. ~ .~ ~ ~. ~.~ ,.,. ~ .. .......................................... <br /> SITE NONBER: 94-~BSB <br /> PHONE: 749-29~2 VALU~T~OH: <br /> <br />TYPE: ~UIM)iNG PERHIT OR APPLICATION NO: <br /> <br />CONTRACTOR, NO. 257e2 <br /> Nichols Construction IRc <br />121~4 W Stayton Rd <br />Au~sville. 77325-0~B0 <br />PHONE: 769-2989 <br /> <br /> ITEM <br />BUILDING FEE <br />PLAN REVIEW <br />BUILDING STATE SURCHARGE <br />ZONING SURCHARGE <br /> <br />PAYEE: <br />RECEIVED BY: PB <br /> <br /> $ THIS IS A <br />CONSTRUCTION CEASES FOR <br />EOUIRENEHTS OF STATE I <br />ALL SECONE NULL <br /> <br /> 52357 <br />ARCHITECT/ENGINEER, NO. <br /> <br />PHONE: <br /> <br />,~TOTAL ASSESSED FEES <br />:.,PRE~IOUSRECEIPTS <br /> <br />QUANTITY AMOUNT <br /> <br /> $64.03 <br /> $4.93 <br /> $4.93 <br /> <br />$172.39 <br />$172.39 <br /> <br />$0.00 <br /> <br />TYPE: CHECK ~: 0 <br /> <br />ITS ISSUE BATE. IF <br /> FAILS TO HEET ALL <br /> ORDINANCES, THIS PERMIT <br /> <br />ENERGY PATH: <br /> <br />REMARKS: STORAGE BLDG <br />~SNAL,,D E. WOODLEY, <br /> <br /> ' i16 SETBACKS: FR 20 <br /> FT: 1440 LS-10 <br />,STORIES: ,, I RS-lO <br />PEANfACTION: RE-30 <br />ENERGY PATH: SR~_~_ <br /> <br />MARION COUNTY BUILDING OFFICIAL / BY ~ . ~ A~ <br /> <br />FORM # M~ 1~-~ R~V. 4/~0 OFFICE COPY <br /> <br /> <br />