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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG. NO, 225 <br />220 HIGH STREET NE <br /> SALEM1 OREGON 97301 <br /> <br /> PHONE: 588-5147 8:00 - 4:30 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />The work wHI be puHormed by a registerod builder <br /> <br /> I have read and agree to the terms stated on the reverse sfde of <br /> th,s document <br /> <br /> OATE: 08/19/g0 'riME: t4:48:30 <br /> <br />OWNER' <br /> N ICHOL,. S'i' EVEN <br /> <br />RD I D~N l I AL <br /> <br />SITUS ADDRESS: <br /> <br /> 12164 WEST STAYTON RD <br /> AUMSVILLE OR <br /> <br />97325 <br /> <br />USE OF BUILDING: <br />MAILING ADDRESS: <br /> <br />OTHER NON-RE,~IDENTIAL BUiLDIN~ <br /> <br />PHONE: ?69-2989 <br /> <br />BLOCK: , ~C~I(DN: TOWNSHIP: <br /> 18 <br /> <br /> CONSTRUCT ON TYPE' OCGURANGY <br /> 5-N M-1 <br /> <br /> CON'ff4AGT CITY UGB OCCUPANT LOAD <br />I~tAR iON COUNTY NO <br /> <br />SUBDIVISION <br /> <br />SITE NUMBER: 4394 <br />VALUATiON: $4,800.00 <br /> <br /> RANGE: ZONE: MAP' <br />98 1N EFU 60 <br />~C 'R~EG, LOT: NO CORNED <br /> <br />TYPE: BUILDING PERf411' OR APPLiCATiON NO: <br /> <br />24170 <br /> <br />CON TRAC'roR, NO. <br />N ICHOL. ~'I' EVF_.~ <br />SA~4E <br /> <br />ARCHITECT/ENGiNEER, NO. <br /> <br />PHONE; 769-2989 <br /> <br /> 1 TEN <br />BUiLDiNG FEE <br />PLAN REVIEW <br />FLEEi' ~JRCHARGE -ZONE 4. <br />BUILDING STATE SURCHARGE <br />Z~ING ~HA~E <br /> <br />QUANTITY <br /> <br />AJ'4OUNT <br /> $50~50 <br /> $32.83 <br /> $5,12 <br /> $2.53 <br /> $2.53 <br /> <br />TOTAL ASSESSED <br />PRE¥iOJ~ RECEIPTS <br />THIS RE~EiP'r <br /> <br />~93.51 <br /> 93.51 <br /> $o,oo <br /> <br />BALANCE <br /> <br /> PAYEE: <br /> RECEIVED BY= P'B TYPE: CHECK ~: 0 <br /> <br />~ THIS iS A VALID PERMIT $ THIS PERf41T ~(PIRELS 180 OAY~ FF~ iTS i~E DATE+ <br />C~ST~CTi~ C~ FOR A PERi~OF 180 DA~, OR iF ~ST~C'Fi~ FAI~ TO MEET ALL <br />REQUIREMENTS OF STATE ~ ~D ~RI~ O~NTY BUiLDiNG ~O Z~NG ORDIN~C~, I'Hi~ PE~I'I' <br />~ALL BEdE NULL ~O VOID. <br /> <br />SETBACKS: FR ~ L,~ 11 ~ 11 RR 11 SP <br />REMARKS: POLE STORe, GE 8LO~ R~241'1APPRO~EO'"'FOR PRIVATE NONCOC'~ERCIAL USE ONLY. ~MU~'F BE, <br /> LC~ATED ENTiRELY BEHIND THE RESIDENCE <br />HEIGH'I't 19 'f'OTAL SO. FT: 1200 STORt~: 1 PLAN.ACTION: <br />0ONALD E. ~FOODLEY, MARION COUNTY BUILDING OFFICIAL / BY ........................................................... ~.[/~> .............................. <br /> <br />OFFICE COPY <br /> <br /> <br />