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MARION COUNTY BUILDING INSPECTION <br /> SENAT(;ZR BLDG. NO, 225 <br /> ;~220 HIGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br /> PHONE 588-5147 <br />CODE-A-PHONE 4:30 EM, - 8:00 A.M. <br /> <br />I am a registered builder OR ( ) the authorized representative <br /> <br />The work will be performed by a registered builder, <br />Other ........ <br /> <br />SIGNATURE OF APPLICANT: <br /> <br /> DATE: <br /> <br />R~IDENTIAL <br /> <br /> 11808 11848 DUCK INN ROAD t~?NE , <br />GERVAIS OR ,'97026:;,. 5. <br /> <br />CONTRAil ~ITY; UGh: L~AD: <br /> <br />~3848 DUCK INN RD NE <br />GERVAIS, OREGON, 97026 <br />PHONE: 792-4259 <br /> <br />· ,', .... SITE NUNBER: 4643 <br /> VALUATZON,: <br /> <br />MAP; <br /> <br />WIDTH; DEPTH: <br /> <br /> AREA; 85 <br />: ;, 28. 0000 <br /> <br />18 <br /> <br />TYPE: NOSIL~,HOME..~, '~PEf~l:lTOR APPLICATION NO: <br /> <br />CONTRACTOR. NO. 14876 <br />NESTEI:~"4 LIVING <br />4835 PORTLAN:D ROADNE <br />SALE~. ORESON97305 <br />PHONE: 393-7353 <br /> <br /> ITEM <br />~08 ILE ~ ~l~T WIDTH <br />MO81'LE HONE ADDTL. WIDTH <br />f~f/D81LE HONE ZONING <br />FLEET ~A~E:-Z~E 4 <br />~,iLE H~E STATE ~R <br /> <br />~ '[l't~ I$A VAL:I~) ~T::~ <br />.'~I0~ FOR <br />REQUI RENENl~ OFxs'rATE <br />E~i~..L,SECONE NU~ AND <br /> <br />REMARKS: MOBILE HONE ~O.~h;Pl~7311' ~ <br /> <br />$115.12 <br />$115.12 <br /> <br />$0.00 <br /> <br />,.. THIS ~T ,,, <br /> <br />OFF]CE COPY <br /> <br /> <br />