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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 8:00 - 4:30 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />I am performing work o~1 a grogorty I own or occupy. <br />I am ~t reglstered builder OFf ( ) the authorized repfesentabve <br />of a registered builder, <br />The work will be performed by 8 registered builder, <br />Other. <br /> <br /> I hsve read and agree to the terms ststed on the reverse side of <br /> this doGumsnt. <br /> <br />DATE: 05/14,/93 <br /> <br /> GfiSXI'f'ZLER, ~N <br /> <br /> 10523 PORTER RO SE <br />AUtcC~¥1LLE OR 97325 <br /> <br />MA~LING ADDRESS: ¢~iNGLE FAt-4~LY O,~HELLIN~ <br /> <br />S~GNATURE OF APPLICANT: <br /> <br /> TAX LOT: <br /> <br /> CONSTRUCTION TYPE: <br /> <br /> 5--.N <br /> <br />ffTAR!r.~l COUNTY ' <br /> <br />NO <br /> <br />CATEGORY: <br /> RESi DEN 7' 1 AL <br />OCCUPANCY: <br /> <br />10663 PORTER RD SE <br />AUiV~ViLLE <br />PHC~E: ?49-2640 SiTE NUMBER: 10593 <br /> VALUATION: $17,280.00 <br /> <br /> ~ NO <br /> ; 66. AC j NO ~ <br /> <br />TYPE: BUiLDiNG PERI~I'f OR APPLICATION NO~ <br /> <br />CONTRACTOR, NO. <br />GEN'I'ZLER, ~ <br />10663 PORTER RD SE <br />AUf4SViLLE <br />PHONE: ?49-2640 <br /> <br /> I'I'B~I <br />BUILDING FEE <br />PLAN REVIEW <br />BUILDING SI'AI'E BURCHA~E <br />ZONING SURCHARGE <br /> <br /> 31830 <br />ARCHITECT/ENGiNEER, NO. <br /> <br /> QUANT 1TY ArcIOUN'T' <br /> $~28.50 <br /> $83.53 <br /> $5.4~ <br /> . $6.43 <br /> <br />:TOTAL :A.S~ED FEES $2~4.89 <br />PR~i~S RECEIPTS $224+ 89 <br />THt~ R~Ei PT $0.00 <br /> <br />BALANCE OUE $0.00 <br /> <br /> PAYEE; <br /> RECEIVED BY: PB TYPE: O~ECK ~: 0 <br /> <br />~ THIS ~S A VALID PER'lIT * THIS PEfr~IIT P..,"XPiRF-~ 180 DAYS ERGO4 ITS ~E DATE. IF <br />CONSTRUCTION CE.A~E:~ P~R APERiOD OF 180 ~Y~, OR iF~S'r~c'ri~ FAi~ TO ~EE'f' ALL <br />REQUIREMENTS OF STATE ~ ~O ~Ri~ ~NTY BUILDING ~0 Z~ING ORDiN~CES, THiS PE~I'T' <br />~ALL BEdE NULL ~0 VOIO. <br /> <br />SETBACKS: FR 20 L$ / RS 10 RR 30 SP <br />RE~4ARF¢5: f4ASTER BDR~ & BATH ADDiTiON R:l~t3577'-' <br /> <br />HEIC44'T': 'fOTAL ~ FT: 384 STORI~: 1 <br /> <br />~ALD E. ~DLEY, ~RI~ ~NTY BUILDING OFFICIAL / BY <br /> <br />PLAN+ AC'f 1 ON: <br /> <br />OFFICE COPY <br /> <br /> <br />