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MARION COUNTY BUILDING INSPECTION
<br />SENATOR BLDG, NO, 225
<br />220 HIGH STREET NE
<br /> SAt_EMi OREGON 97301
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<br /> PHONE: 588-5147 8:00 - 4:30
<br />24 HOUR CODE-A-PHONE: 588-7904
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<br />of a registered builder,
<br />The work will be peHormed by a reDistered builder.
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<br /> 76~ CLEVEI,,~ND .... , , ,~
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<br /> PO BOX 267
<br /> AUHSV'.tLI,.E, OR 9752'5 SITE WO~BERJ 95-88884
<br /> PHONE: 749-2471 VALUAT I ON: $7 ~ 776,, ~
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<br />IYPE= BUIL~g PERMIT OE APPLICAI'ION NO:
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<br />AI~CHITECT/ENGINEER~ NO.
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<br />PHONE:
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<br /> :l: 'f F M (:~ U A N T I T Y A M 0 U I'] 'l
<br />8UZI..DING FEE $6~3.5~)
<br />PLAN REV:fEW $4.4,, 53
<br />I~UZ!_.OIN6 S FA fE SURCHARGE $S,, 4:;
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<br />PAYFE.,
<br />I",ECEiVCf) BY: DF TYPE: CHECK :1~,: 0
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<br /> · THIS IS A YALID PERMIT,., THIS'PERMiT~,EXP,~RES':t88 'BAYS FEOM ITS ISSUE DATE. IF
<br />CONSTRUCTION CEASES FOE A 'PER~OS,"OF~,',~,88,~YS~,:,,',OR','~F 'CONSTRUCTION FAILS TO MEET ALL ,
<br /> EQUIREMEHTS OF STATE L~WS AND ~ARi~N::COUNTY 'BUILDING AN~ ZONINg ORglNANCES, THIS PERMIT
<br /> ALL BECOHE NULL AND VO:I~,:~', , :: :::, : , ,
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<br /> '. ~ TOTAl_ SG FT: 864 LS"7
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<br /> ~ ..A ~, AC []. 0 RR"7
<br /> : ENEN(,Y PAT4: SF""
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<br />I,,lOt]I)l,C¥~ MA,',,t,,h L'OUHT¥ ]~d.l,~l.,,gJ:NC; OrFlf.,IAl,,, / tiP(
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<br /> OFFICE COPY
<br />FORM # MC 15-5(I REV. 4/gO
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