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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 <br />CODE-A-PHONE 4:30 P.M, - 8:00 A.M. <br /> <br /> am perforrTdn9 work On a property I own or occupy, <br /> an/8 reglsteredbu{IderOR( )theAuthorlzedrepresentative <br /> of a registered builder, <br /> Th6, work will be performed by a reDistered builder. <br /> OtherL <br /> have read and agree to the terms stated on the reverse side of <br /> <br />?AT~: 05/*'.5/8? TYv!E: ! !:27:548 <br /> <br />TAX LOT: <br /> <br />CONSTRUCTION TYPE; <br /> <br />SITUS ADDRESS; <br /> <br />973O2 <br /> <br />NE <br /> <br />MAILING ADDRESS: <br /> <br /> ;:>H(:)i'l~:,7 7S. 221:3 <br /> <br /> N_Ivt8_-< <br />SITE ='" <br /> VALU,aT T ON: <br /> <br />TOWNSNIP: RANGE; <br /> <br />UNITS: ' I~REEL LOT: <br /> <br />ZONE: <br /> <br />CATEGORY: !~ <br />OCCUPANCY: <br /> <br />OCCUPANT LOAD: <br /> <br />1214 <br /> <br /> MAP: <br /> <br />f'¥P[,'_'; IviECH/',NtCAL <br /> <br />DOMESTIC WOOD STOVE <br />:v!ECF4ANTCAL. SASE FEE <br />,:::L!-','E'f' SURCHARGE -ZO~.'.E <br />:vI¢~cI-r~\,'4'[~-.'AL STA'"?"_" ,<'}URCHAC~GE <br /> <br />PERN]:T OF; APPLICAT!C~ NC: <br /> <br />.... ~, ~ ASSESSED FEES <br /> <br />*,.F40L N T <br /> <br />$25.3S <br /> <br />c*:,CETVEZQ S¥: CL ........................................ TYPE: C!t ,.,H,'_'C,K 905 <br /> <br />* ~'H,]$ iS A VALID ,~'¢~iT ~ 'TH~S PERMIT EXPIRES 180 DAY~ FRO~ [TS ISSUE DATE. IF <br />CONSTC~UCTION C~ASF_~ FOR A PERIOD OF 180 DAY<&, OR IF C~.NSTRUCTIC~ FALLS TO ~I~E? ALL <br />RE(~J~RE~F~NTS OF STATE LAWS AND J~IARION CC~JNTY BUILDING 'AND ZONING ORDINANCe, ,'THIS PERMIT <br />SHALL BECC~ NULL AND VOIO_ <br /> <br />}QI'IALF) c FiOOi3LEY, ~'IARIOF4 COUNTY ~L ~LOING OFFICIAL , BY <br /> <br />OFFICE COPY <br /> <br /> <br />