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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG. NO. 225 <br />220 HIGH STREET NE <br /> SALE~, OREGON 97301 <br /> <br /> PHONE: 588-5147 8:00 - 4:30 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />The work will be performed by a registered builder. <br /> <br /> DATE.* 05/16/90 TIME= 11 .*32.*09 <br />OWNER. BORLAN0, LARRY <br /> <br />SITUS ADDRESS: <br /> <br /> 104 FOREST SERVICE RD <br /> D~I'~I 1' OR <br /> <br />97342 <br /> <br />NE <br /> <br />USE OF SUILOING' ' ...... <br /> SINGLE FAC41LY E~ELLINGS <br />MAILING ADDRESS: <br /> <br /> RT 3 BOX 460 <br /> HILL~8ORO, OR 97124 <br /> ~E: 647-2980 <br /> <br />LOT: BLOCK SECTION TOWNSHIP <br /> 104 21 <br /> <br />WIDTH 120DEPTH '~5 AREA: 19800. UNITS: <br /> <br />SIGNATURE OF APPLICANT: <br /> <br />DATE: <br /> <br />DATEGOHY R~I DEN'1' iAL <br /> <br /> CONSTRUCT DN TYPE <br /> 5-N <br /> <br />6ONTRACT CITY JGE <br />'~RlOf~ C'EX~N I'Y <br /> <br />SUBDIVISION <br /> <br />NO <br /> <br />DCSUPANG' <br /> <br />OCCU PAN'f LOAD: <br /> <br /> NO OF 8EDR00MS <br /> <br /> 1 <br /> <br />DEVIL'S CREEK ~UI"41'4ER TRAC'1S <br /> <br /> 8I'1'E NUt, lEER: 99r53 <br /> VALUAT ION: $28,138.00 <br /> <br /> RANGE ZONE: MAP' <br />98 1 E i'D <br /> <br />~F RREG LOT NO CORNEF~o <br /> <br />102 <br /> <br />TYPE: BUIL01NG PEF¢,Ii'f' OR APPLICATION NOt <br /> <br />CONTRACTOR, NO. <br />DORLANO, bARRY <br />RI' 3 BOX 460 <br />HILLcSSORO, OR 97124 <br />PHONE: 647-2980 <br /> <br /> ITEM <br />BUILDING FEE <br />PLAN REVIEW <br />FLEET SURCHARGE -ZONE 7 <br />BUILDING STATE SURCHARGE <br />ZONING SURCHARGE <br /> <br />PAYEE= <br />RECEiVED BY; PR <br /> <br /> 23405 <br />ARCHiTECT/ENGINEER, NO. <br /> <br />TOTAL ~E~3,~E D <br />PR.E~,~,iOU$ RECEI P'rs <br />'tH ZS! RECEi P-r <br />BALANCE DUE <br /> <br />Q~AN'I' i TY <br /> <br />A~4OJN'T' <br /> $188.50 <br /> $122.53 <br /> $8+96 <br /> ~9.43 <br /> 9.43 <br /> <br />¢338.85 <br />338.85 <br /> $o.oo <br /> <br />TYPE: CHECK ~: 0 <br /> <br />$0.00 <br /> <br /> x~ 'IHIS iS A VALID PERMIT ~ THiS PEril' E~<PIRE8 180 DAYS FROM iTS I~E BATE. <br />'C~s'r~c'rI~ C~ FOR A PERIOD OF 180 OA~, OR IF ~S'r~c'ri~ FAI~ TO MEET ALL <br />RE~IREMENI'S OF' $TATE LA~ ~D ~RI~ ~N~Y BUiLDiNG ~B Z~NG ORBIN~CES, THiS <br />~ALL BEG~E NULL ~O VOID. <br /> <br />SETBACKS: P'R LS RS RR .SP <br />RE;f~ARKS: REPE.ADE-'RE.~ BORRT Oo¢~"APPRX 1078~'7 NO P~B~ELEC REP~ED UNDER <br /> P~ViSI~S OF ~20 138.060 (A) ~ <br />HEi~'F: 25 TOTAL ~ F'f': 1100 s'FoRi~: 2 ' ' - <br /> <br />~ALB E. ~BLE~, ~R~ C~NTY BUILB~N~ OFFICIAL / BY %.. .......................... <br /> <br /> OFFICE COPY <br />FORM # MC 1 ~.~{i REV, <br /> <br /> <br />