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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: 588-514.7 8:00 - 4:30 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />I am 8 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 />....OWNER,~)~ I,., ,,:' ":'" ..... I270'V79," - ~ ........ TIM~'"~ w.,,,,, ~.j.-m;.~=,~.. ~ .............................................................................................. ~ TAX LOT; <br />....... ~ [EL~At% ~ ........................ ~ ..... <br />S~TUS AOO~ESS; ......................... ~f¢dC¢~5~*+~: ............................... <br /> <br /> ~4~ ~PI-N DR ' SE ~o ~o~f~'8~-8~ ...... <br /> <br />us~ 5~ ~u~: ' "--~-~ .................... ~ .................... [~' ~ ~o~Oo~. <br />~ 4. . <br /> <br /> ~-~N~,- E B T h TE~ ............................................. <br /> <br />TYPE= BUILDING <br /> <br />PERMIT OR APPLICATION NO: <br /> <br />CONTRACTOR,, NO. 14922 <br />COMH WoodbuT-n .T. nc <br />285 S Pacific Hwy <br />Wctodbur~. 97071-0000 <br />F'FIOI~ L"~: r/8.1,-;~:i. 41 ' <br /> <br />BUILDING FEE <br />PLAN REVIEW <br />BUll. D~NG STATE SURCHAE~E <br /> <br />PAYEE: <br />RE¢EIVED BY: CR <br /> <br /> · THIS IS n VALID <br />CONSTRUCTION <br /> E~UIREHENTS OF <br /> ALL BECOME NULL AND <br /> <br />ENFRI;Y PATH: <br /> <br /> 51398 <br />ARCHITECT/ENG~NF'ER~ NO. <br /> <br />:EES <br /> <br />QUANTITY <br /> <br />AMOUNT <br /> <br />PATH: <br /> <br />TYPE: CHECK ~: 0 <br /> <br />ITS ISSUE DATE. IF <br /> FAILS TO MEET ALL <br /> ORDINANCES, THIS PEEHIT <br /> <br />300 <br /> <br />FORM # M(~ 15,5~ R~"V. 4/~0 OFFICE COPY <br /> <br /> <br />