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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:$0 <br />24, HOUR CODE-A-PHONEi 588-7904 <br /> <br />lamaregisteredbullderOR( ) the authorized representative <br />Other, <br /> <br />i have read and agree to the terms stated on the reverse side of <br />this document, <br /> <br /> ,B'ITg~ ASd~S'-~S; ~ ~' .... ~ ~'~ ( CORSTRUCTION TYPE; OCCUPANCY: <br /> <br /> AL~HSV)~L[,,E OR 97325 MARION COUNTY NO <br />~O~E O~ 801[DIN~; .................................................................... ~NO OF BEO~OOMS <br /> <br /> / SITE NUHIEE= 94-81713 <br />: PHONE;: 769--2292 ~ VALUATION= <br /> <br /> PEI~HIT 0R APPLICATIBN NB: <br /> <br />45933; SUPER¥ISING E, LE(.TR.[ C,[ AN/NUMBgI* <br /> <br />?:: ; <br /> ,FEES <br /> <br /> QUANT ]: TY AH(]U N'i- <br /> $42,, 00 <br /> <br /> RECEIF'T NO~ <br /> <br /> REVIE~ PROCESS WHERE THE <br /> APPLICANT TO ASSURE THaT <br /> <br />,DIg FI, ON. BY [)ATE <br /> <br /> ~ TH~S iS NOT A PE~HIT <br />FOLLOWING MUST BE <br />ALL NECESSARY INFORMATIOH <br /> <br /> PLAN ~,~V,[~:[J~ BY <br /> <br />r' NAP'&cL' ff.:. SVC <br /> <br />RM ~ MO ~5-56 ~E'V. 4/90 OFFICE COPY <br /> <br /> <br />