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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 />of a registered builder, <br />The work will be performed by a registered builder. <br />Other <br /> <br />SIGNATURE OF APPLICANT: <br /> <br /> ~ (.[.J I._ ~.,.[.¢,., <br />, SITUS AbDR~$~: J <br /> <br /> !::~-~'~ ~ ~S:".:?. <br /> ;~ ~D~'~ D~::,'~:~(~)~[ '~' ~'~'~ ..... ~ OCCUPANT LOAD: <br /> <br />;USE OF ~O¢CNCN~ .................................................................. [ <br /> ~¢~ ~ ,,:;' r <br /> <br /> ~D~PTH. ~AR~A; ~ UNIT~: ~ I~R~G, LO1'. CORNER; <br />, [ ~99~. 8F ~I0 NO <br /> <br /> CON i RAf,;TOR~ NO., ~RCH~TECT/EI,~G]:NE:ER~ <br /> <br /> D[i); LD ]'NE; f.'~TE : <br /> <br /> ~I,I]],~ZNG ,- iI,tVESTIC~I~ON/bI~U~LE FEE:,~ <br /> <br /> , <br /> <br /> ~: <br /> <br /> · THIS IS A V~L~D <br />CONSTRDCT~ON CEASES <br /> EBUZ~E~EETS OF STATE <br /> ~LL ~ECOHE N~LL <br /> <br />~UANT:~TY AMDUNT <br /> $ :1. 7,, :;8 <br /> <br />$47,, 26 <br /> 'SC) ,, ~2)~'~ <br /> <br />TYPE~ CHECK ,ilu: C) <br /> <br />F~ILS TO HEET ALL <br /> <br />PLAN ~ AC,'F l ON ~ <br />ENERGY F'A:]'H: <br /> <br /> SETBACKS:~ FR 8 <br />(") I...S"¢ <br /> RS"O <br /> <br />,¢,)UO,..,'t.Y? HAR[C)N CQU,~I]'y ~¢U.ILDZEIG. O:F,t:CIAL / ~y <br /> <br />OFFICE COPY <br /> <br /> <br />