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SALEM, OREGON 97301
<br />
<br /> PHONE: 588-5147 8:00 - 4:30
<br />24 HOUR CODE-A-PHONE: 588-7904
<br />
<br />I am a registered builder OR the au hot zed rep esen ave
<br />of a reglstereb builder.
<br />The work will be performed by a registered builder,
<br />Other
<br />
<br /> 520 8Tit ST --
<br /> AIJMSV II,,,LE 0R 97525
<br />use oF 8'UEb]~b'i .....................................................................
<br />
<br />~ 012r 9,61
<br />CONSTRUCTION TYPE'.
<br />
<br />RESIDZNTIAL
<br /> OCCUPANCY;
<br />
<br />TYPE: DWEELING PERMIT (IR APPLICATION
<br />
<br />CON'IR~¢'~OR~ NO,, 00315
<br />D[;F' '[HVEST~ENTS
<br />1~84 SW };ERTHN BI.VD
<br />
<br />PI-I(INE: 24&-~e95
<br />
<br /> :'rEH
<br />DWELLING BI,III.,I)IIq6 FEE
<br />PWEU,,;[ N6 PLUMBING
<br />
<br />DWf;:LLIN6 ST~'TE SUREHRR6E
<br />
<br /> 6e267 DP
<br />ARI;FII'FECT/ENG I NEER ~ NO.
<br />
<br />PHONE:
<br />
<br />IQ:IAL, ¢~SSES.~ED ~FEE8
<br />,PREV-I 0 ]S ' RECEI PT$
<br />THI,S R'ECE IPT
<br />
<br />QUANTITY
<br />
<br />AHEiUNT
<br /> $248.75
<br /> $90.70
<br /> $22.60
<br /> $70.03
<br /> $2:~ ,. 64
<br />
<br />$63%, 52
<br /> $0,, 00
<br />
<br /> F A¥~;rr. A~LANCE"DUE $0 00
<br /> RE;EIVE'¢ ~Y.- DF" .- ';~' ~ '.';;,," ":': ~,,.,-. ~ . . '
<br /> ...... '".ZZ,: ' ' · ................ = ............. ~g~_%~z~h~:,~," ,, ~n"~. ur~ECix :~. 0
<br /> ~ THIS ~S A V~LID PERMIT., TH~$ PERHI~;'~XPIRES',,18~,~A~S FROM IT~ ISSUE DATE. IF
<br />CSN~TRUCT[SN CEASES FOR A~ PERZDDOF',.~8%,~S,',,,OR:"I~,' ~ONSTRU8TION FAILS TO MEET ~LL ~
<br />E~UIREHENTS OF STnTE LAWS ~ND"H~RION 'COUN~Y"DU[E'D~N6' AND' ZONING DRDZNANOE~ TN~ P~RM~T
<br /> ~LL ~ECBHE NULL AND VOID.. " · ,, ,.,, ',, ;; · ,. ~ ..
<br /> , ~ , . ,:'. : ' 'HEZGHT: OETS~CKS~: I','.'l'.~ 2B
<br /> TOTAL 5Q FT: 1546 i...~;""',(:.'
<br /> E],~:Rfi Y F'hTbh ' STORIES: ~ RS'"'5
<br /> PLAN. ~6'f'ION: RR-' 1 I
<br /> ' ' ENERGY P~TN: 8 sr,:,"-
<br /> RF.H~tRKS~; NI:,,H RES
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<br /> OFFICE COPY
<br />~ORM # M6 f~-$$ REV, 4/~0
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