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MARION COUNTY BUILDING INSPECT
<br /> SENATOR BLDG. NO. 225
<br /> 220 HIGH STREET NE
<br /> SALEM, OREGON 97301
<br />
<br /> PHONE: 588-5147 8:00 - 4:80
<br /> 24 HOUR CODE-A-PHONE: 588-7904
<br />
<br />I am performin9 work o¢~ A property I own or occupy,
<br />I ,am a registered builder OR the Authorized represen a ye
<br />of ~ registered builder,
<br />The work w~ll be performed by a registered builder,
<br />Other ,,__
<br />
<br />OwNE~f/TE ~'0
<br />
<br /> WEE:SE KEH
<br /> SITUS AO~BE~;~ CONSTRUCTION
<br />
<br /> ,;[ALE~, OR [ SITE NUMBER,
<br /> F. HE;NI~:: 37:[.,-8412 ~ VALUATION:
<br />?0~: ]BLOCK'. SECTION: ~TOWNSHIP: ~ RANGf: [ ZONB: ', ~
<br />iWID~H, EPTH; ~3" -- ~0~1 ~EG, LOT;
<br />
<br />TYPE: I)WELLIN6 PERMIT OR APPLICATION NO:
<br />
<br />I;ONTNflCTOR.~, NO. 86496.
<br />OYNAMO CONSTR,, CHARLES LIHI)ORFE
<br />
<br />,~,a GLEN CREEK RI) NW.~
<br />~aZf. em~ 97394'-0000
<br />F HONE: 391"'6612
<br />
<br /> ~6t~61~8 DP
<br />AR(;HITECT/E ~ G 1, EER~ NO.
<br />
<br />SUITE ;~00
<br />
<br /> PHONE:
<br />
<br /> ITEM
<br />I)WEL,LING BUII..DI:N(; FEE
<br />bWEL, L I N(.;. PLUi'iB IN§
<br />O W,~:I,. L .l[ IGC,; HECHANT, CAL
<br />OWELLING ELECTRICflL
<br />I)WEL. LII,IG ~;TA'fE SURCHARQE
<br />DWELLING PLAN REVIEW
<br />
<br />QUANTITY
<br />
<br />AMOUNT
<br /> $473.85
<br /> $172.70
<br /> $4;%05
<br /> ¢104., 92
<br /> $41.2~
<br /> $185.00
<br />
<br />$ I ~ 050.83
<br />!i; :1.,~ 0,5(] ,,
<br />
<br /> F'f~YEE: DYHAHO CONS'rE. , ::' .....
<br /> ,., .... ::: , ,,: 63 ,,:. ,:. 7
<br /> RE.I,E,[W,D ~Y: PH ::::::, :TYPE: IN CHECK ~:
<br /> * THIS IS NOT A PERMIT.:: A REVIE~ PROCESS WHERE THE
<br />FOLLO~IN~ HUST BE
<br /> L .... ~-- . .... HE APPLlC~I TO A~SUEE THAT
<br />
<br /> -,~:t ~J.~,.; t~f ....... ~/E $TORZES~ 2: % ~;'q'"¢~
<br />
<br /> , . :'FE~6Y PATH= ,~ % S"-"
<br /> (',ZTY .JUR~S~)ZLTZOH; 8Y ~TE "" :" .............
<br /> RE.N~RKS; HEW RES .... 7' ....... ::F :
<br />
<br /> OFFICE COPY
<br />CORM # MC 15-~ REV. 4190
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