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MARION COUNTY BUILDING INSPECTION <br /> SENATOR BLDG. NO. <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 S reg{stered bullde¢, <br /> <br />Other <br /> <br />I havS read and agree to the terms stated on the reverse side <br />this document, <br /> <br /> D&F...,I ~IV£S Z MEi, kT S .......................... <br />; SITUS ADDRESS'. <br /> <br /> 6~5 9TN ST -- <br /> ALIH,¢/II..L.E OR ~7~25 <br /> <br />CONSTRUCTION TYPE: i OCCUPANCY'. <br /> <br />AuMSVILLE iNO <br /> i NO OF BEDROOMS <br /> <br />........ S I N~,;LE..E AJf~ L.¥ .-DM}EL LI,~t~S. ......................... = ......................... <br /> <br /> ~49;~ LA'rOMA Cf NE <br /> KE:[Z~R, OR ?'73~'3 SITE NUMBER: <br /> PHONE: 37~-7829 VALUATION: <br /> <br />TYPE: DWELLING PERMIT OR APPLICATION: NO: 6~868 DP <br /> <br />f;ONT,.:,ACTOR. NO. ~;J15 ARCHITECT/ENGINEER~ <br />DGF' INVESI-~ENI'S <br />i~4 SW BER'rHN BLVD <br /> <br />PHONE~ ~46,,-.~B~5 ::, :,:' <br /> <br /> ITEM <br />~WELLZNG BUZLD~NG FEE <br />DWEt,.L1NG PLOMBIN8 <br />~WELLING ~ECHANICAL <br />~WEI.,LING ELELTRICAL <br />D~¢EL.L l NGS ~ AT... SURCHAt~ <br />D~IEI,.LING PLAN REVIEW <br /> <br /> PAYI{E: <br /> R~;CEiVED BY~ DF' <br /> $ THIS IS A VALID PER,Il <br />CONSTRUCTION CEASES FOR!~ <br /> EQUiRENEHTS OF STALE <br /> ALL BECOME HULL AND <br /> <br />NO. <br /> <br />QUANTITY <br /> <br />TYPE: CHECK ~: <br /> <br /> ITS ISSUE BATE. IF <br /> FAZES TO MEET ALL <br /> <br />AMOUNT <br /> $254.54 <br /> <br /> $2~,.12 <br /> $72,,48 <br /> $22.15 <br /> $185,.~0 <br /> <br />$650.1 :L <br />$/.~. · .L <br />$0. <br /> <br />:: 0 S£'FBACKS: F'R 28 <br /> <br /> :!: ': ........ TOTAL S~ FT: <br />_PAI'N: _t ::': <br /> F'L AI~ ACTION: <br /> ENERGY PATH~ <br />, NEW RES - AUMS~;LE <br />E. WDODLEY.j MARl:ON COUNTY BUZ[..DING OFFtC]:AL / BY <br /> <br />1582 LS ,,~ <br /> <br /> ~:~R ,, <br /> SF'Z .......... <br /> <br />OFFICE COPY <br /> <br /> <br />