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The work will be performed by a registered builder. <br />Other <br />I have read and agree to the terms ~tated on the reverse side of <br />this dooument. <br /> <br /> 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 />lam <br /> performing <br /> WOrk <br />I 8,m a registered builder OR the authorized representative SIGNATURE OF AFPL OANT <br />of a regis ered bu der, ' <br /> <br /> 1 <br /> <br /> AURORA, DR 97e82 SITE NU~ER: 94-e~26~ <br /> ) HON,:,, ~7~) -.. 85, VALUATZON,,,, ~5,,~ 8~). ~ I <br /> <br />F-- <br /> <br />CO, I f kAL FO~'~.,~ NO,,, <br />NORTH EqRIOlq SCHOOL <br />2~256 GRIN RD <br />ALIRCRA~, OR <br /> <br /> ITEM <br />BLItt...DIFIG FEE <br />PL, AN REVIEW <br />BUIL, DZM~i STATE SLtRCFA~SE <br />Z[)t,I I N[; SLIRCFIARGE <br /> <br /> ARCFilI'ECT/ENE- Z NI~:ER ~ NO. <br />I~ISTRZCT~/ .~ <br /> <br />(]UANT :[ TY AM01,H,FT' <br /> <br /> $52. <br /> $2.53 <br /> $2.53 <br /> <br />$88. ~9 <br /> <br /> 54838 <br /> TYPE: CE CHECK 8: 24548 <br /> <br />A REVIEW PEOCESS WHERE THE <br /> APPLICANT TO ASSURE THAT <br /> <br /> SETBACKS: F'R,,,.~ <br />0 L.S <br /> RS...~. .... <br /> RR "~'-' <br /> <br />FORM # MC ~-~ REV. 4,/~ OFFICE COPY <br /> <br /> <br />