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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG, NO, 2~5 <br />220 HIGH STREET NE <br /> SALEM, OREGON 97501 <br /> <br /> PHONE: 588-5147 8:00 - 4:30 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />~ am a registered builder OR ( ) the autl~orlzed representative <br />of a reglstere'~ builder. <br /> <br />AUMSVILLE OR 9732~ ~ ~ ~y~_~ ~ <br /> <br />2746 FRONT Sl' NE <br />PHONE; 588-~3~ <br /> <br />TYPE: DWELLING <br /> <br />COI,FI!'RACTOR. N!],.. 00~15 <br /> <br />F'ORTLAItlt)v 972:1.?-0000 <br />PHONE: 246'-';e95 <br /> <br />PERHIT OR APPLICATION NO: 9~68§47 DP <br /> ARCHITECT/ENGINEER~ NO. <br /> <br />:,:' PHONE: <br /> <br />ITEM <br />DWELLIH(; BUlL. DING FEE :: <br />DW .F.L.L I NG F'LOMB~NG <br />Dt, hI:.-LL I i~G MECHANICAl. <br />9WELL. IHG ELF'CTR'.[ gAL : <br />DWELLING STATE SURCHARGE <br />DWEI. I,.IHGPLAN REVIEW , <br /> <br />QUANTITY <br /> <br />PAYEE: DGF INVESTMENTS <br />RECEIVED BY: NB .............. <br /> <br />AMOUN'f <br /> $252.93 <br /> $92.23 <br /> $22~98 <br /> $72.02 <br /> $22.01 <br /> $185.00 <br /> <br />$647.17 <br /> $~,,00 <br />$647.17 <br /> <br /> tYPE. <br />..... . IN CHECK ~: 0 <br /> <br />* THIS IS NOT A PERMIT.: <br />FOLLOWING MUST BE COHPLETED. <br /> LL NECESSARY <br /> PI.AI,I REVIFH,", BY~,.~('~ <br /> Zf]HIFIG; BY <br /> ~:¢EP'Y' I C: BY, ...................................... <br /> <br />t.,llY ,.IURI,i DIbTION, <br /> <br />BY .................. DATE___;= ......... <br /> <br /> REVIEW PROCEB8 WHERE THE <br /> APPLICANT TO A~SUf~E THAT <br /> <br /> SE I '. <br />T.OTAL SQ :PT: 1572 l..s ........ <br />~TORI:ES: 1 ~ ,, <br />PLAI~. ACTIOH: R R "'Z Z~'~ Z_~ Z'~ <br />ENEk6Y PATH: 1 SP. .......... <br /> <br /> OFFICE COPY <br />FORM # MC 1 :-~t~ REV. 4/9O <br /> <br /> <br />