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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 Own or occupy. <br /> I am a registered builder OR ( ) the authorized representative S GNATgRE OF AP~L CANT: <br /> of ~ registered builder. <br /> The work will be performed by a reD[stereO builder. <br /> <br />'(~ ~ TA~ LOT~ ~ CATEGORY: <br />C~MPBELL, HOH[:,~ I RESiDENTIaL <br /> <br /> ~L NSVZL. L.E 3R 97:~25 ~I,JH~VZL,,L,E ~JO [OCCUPANT LOAO: <br /> <br /> RES~)EIqT~I.. A(';CESSOEY STRUCTURES <br /> <br /> ~[LL CREEK EST~TE~ <br /> PO ~OX 279 ~ ............................................ <br /> HUBBARD. OR ~7032 ~ SITE NUNBER~ <br /> PHONE: 781'-4125 r VALUATION: <br /> <br />TYPE: BUILgIN~ <br /> <br />PERHIT OR APPLICATION NO: <br /> <br />C~N1RAOTOR~ NO~ 989~] <br /> Capitol Awning / Sal~iam HO <br />5~.8 Valleywood'Dr SE. <br />Sale~ 97306 <br />PHONE: 36~-171:L <br /> <br />ARCHITECT/ENGINEER~ NO. <br /> <br /> PHONE <br /> <br /> ITEI~ QUANTITY AMOUNT <br /> PLAN REVIEW $28,, 93 <br /> BUILDING STATE SIJR[:HARGE $~.,,.,,,j¢~ ~" <br /> <br /> PAYEE: Capitol Awning /: '~.'"'"' 633~2 <br /> RECE:~VED BY: PM ' <br /> <br />__~. ~IS l~ NOT A PERMIT., ~,~,AP~L~C~T~O~',;~HUST',~ :THROUGH A EEVIE~ PROCESS WHERE THE <br />POLLUWIN~ ~UST BE C~NPLE~ ~ ~ ~HE ~RESS~iBIE~J~Y; OF THE APPLICAHT TO ASSU~E THAT <br /> <br /> ......... A~E,, . -L,-- _.. . <br /> SEPT[C, 8Y A~ ....... <br /> : P~AN. ACTION. RR'"'I~ <br /> CITY JURI~ID~CT:U')N= BY ........... DATE ............ ~.,...~ .... ENERGY 'PATH; SP-]~ ........ <br /> RF:MARKS= ~ CARPORT ::- SP~ "~'~4 - ' ' <br /> <br /> OFFICE COPY <br />FORM 4I MO 15~56 REV, <br /> <br /> <br />