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MARION COUNTY BUILDING INSPECTION <br />SENATOR B~.DG. NO. 225 <br />220 HIGH STREET NE <br /> SALEM,., OREGON 97301 <br /> <br /> PHONE 588-5147 <br /> CODE-A-PHONE 4:30 P,M. - 8:00 A,M. <br /> <br />The work will be performed by a registered builder, <br />Other. <br /> <br />I have read and agree to the terms stated on the reverse side of <br /> <br /> 8OCK, HENRY <br />SITUS ADBR6SS: <br /> <br />TIME: 2.'51: <br /> i TAX LOT'. <br /> <br />CONSTRUCTION TYPE: : OCCdPANCY: <br /> <br />RESi0ENTZAL. <br /> <br /> 110 <br /> SOUTH <br /> OR 97342 / <br /> TUIVBLE ST iCONTRACTCITY: i UGB: ,OCCUPANTLOAD: <br />DETROIT <br /> _OEZ.r;~O,~ NO ' <br /> <br />830 ELECTRIC ST <br />SALEM 97902 <br />PHONE: 585-1713 <br /> <br />LOT: BLOCK: <br /> <br /> 13 15 <br />WIDTH: DEPTH: <br /> <br />SITE NUMBER; 4009 <br />VALUAT I ON: <br /> <br />2 <br /> <br />'"PIPE: MOBILE HOME <br /> <br />CONTRACTOR, NO. <br />BOCK, HENRY <br />830 ELECTRIC ST <br />SALEN 97302 <br />PHONE: 585-1713 <br /> <br />PERMIT OR APPLICATION NO; 8480 <br /> <br /> ITEM <br />MOBILE HOME FIRST WIDTH <br />,~OBILE HOME ZONING SURCHARGE <br />FLEET SURCHARGE -ZONE 4 <br />MOBILE HOME STATE SURCHARGE <br /> <br />' ;'i:PREVIOUSRECEIPTS <br /> THIS. RECEIPT ' <br /> <br /> BALANCE DUE <br /> <br />~ANTITY <br /> i <br /> <br />:338.50, , <br />$0,00 <br /> <br />PAYEE; 8OCK, HENRY INVOICE NO: 92?? <br />RECEIVED BY: ~ .... L~ TL~ ...... = _~T~PE; iN CHECK ~: 0 <br /> <br />~CTI~ C~ FOR A PER,OD OF:lBO DAY,OR IF ~ST~CTI~ FAI~ TO NE~ ALL <br />REdIReCTS OF STATE ~ ~D ~RI~ ~N~ BUILDING ~D Z~ING ORDIN~C~. ~IS PE~T~ <br /> <br />REIVlARKS: MH REPLACEF1ENT <br />RLANN ING ACTION: <br /> <br />DCNALD E. NOOOLEY, IVlARION COUNTY BUILDING OFFICIAL / BY <br /> <br />¢O~M ~ ~c ,:~-.~. ..-v ~/~ OFFICE COPY <br /> <br /> <br />