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- ~ Appl. R'c-~L <br /> <br />B¥~ <br /> <br /> 4/2,/?6 <br />Date:, <br /> <br /> MARION COUNTY <br /> DEPT. OF BUILDING INSPECTION <br /> 3180 Cent~ St_, N_E. <br /> Salem, Ocegen 97301 <br />R,H. WII~4ROW, BLDQ. ADMINISTRATOR <br />588-6147 - 588-514~ <br /> <br /> Permit Number <br />By: __ <br /> <br /> ,J~$ <br />Bldg, Permit: . , <br /> <br />BIdr. & No,: IL;tv ~l'e~=t~ # <br /> <br />Phone: .588-1967 <br /> 399-9705 <br /> <br />Location Permit: <br /> <br /> = City: <br /> <br />Plans by: <br /> M~P~ ~' zo.. '""1 Z~eC~. I'""~'~"- <br /> <br />Lot No- ~ BIk. No: 2__ <br /> <br /> Fea~. <br />Water Supply <br /> <br />Sub dy. Gl~l:t4e Laat~'k <br /> <br />Valuation; ~I 23.~O0~ <br /> <br /> ~1.35 <br />Size of ~u~ .......... <br /> <br /> 1500 <br />Area of Bldg; <br /> <br />Comer? ,, <br /> <br />Pem~it <br /> <br />Plato Chk. Fee: <br /> <br />2.97, <br /> <br />No. of Storie~: <br /> <br />b~tate SurCharge: .... <br /> <br />Type of Roof: '[']cuss .......... <br /> <br />Septic Permit Fee: 25.00 <br /> Rept. NO. ~'"~ / <br /> <br />I agree la butM accoeai~ to ~ mbml~ ,elam ~ ~aecfficati~. ~ i~ ~ ~ ~m of ~ ~ ~ ~/~s ~ ~ <br />~n~. ~mh exp~ ff ~ nor ~ ~ln 1~ ~ <br />SIGNATURE OF ~LI~: ~ ~ ............ <br />MALl DATIO~: <br /> <br />PLEASE NOTE: [~iveway ed skiewelk I~*~ecflonm are required byJ~ub~Lir..Works: 58~J036 <br /> Other Permttl re~Jired by thll del)t: Pltlmbi~g [~ <br /> <br /> <br />