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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 />10/1 f/91 t IMIz: 10.'33:16 <br />SAN f lAM HOMBb <br /> <br /> 220 EVERGREEN DR <br />AU~SVI LLb OR 97325 <br /> <br />MANUFACf'URED 5FRUCfURE <br /> <br />SIGNATUFtE OF APPLICANT <br /> <br />DATE <br /> <br /> TAX LOT <br /> 5?706-000 <br /> <br />CONSTRUCTION TYp~ <br />AUI'45Vi LLE NO <br /> <br /> RES1UEN ~ !AL <br /> <br />OCCI IPANC¥ <br /> <br />OCCUPANT LOAD <br /> <br /> FI4ONE: $IIE NUMBER: 13068 <br /> VALUA'IION: <br /> <br />LOr ELOCK SECTION TOWNSHIP RANGE ZONE <br /> g 25 85 2N RM <br />WIDTII DPPTH AREA UNITS IRREG LOT CORNER__ <br /> 55 <br /> 94 <br /> SF <br /> YES' <br /> NO <br /> <br />MAP <br /> <br />fYPE: MANUFACTURED SfNAJCfURE PEFCO/liE OR APPLICAfJON NO: 36086 <br /> <br />CON/RACIOR, NO. 38238 <br />Oaniel L Carver <br />11373 Mffll (;reek Rd <br />Aumsvit'le, 9/,2!5-0000 <br />PH(.~IE: 769-7?44 <br /> <br />~¢~NUFACfUREO 5fRUC lURE PLACENEN ¥/(Y.)NNEC f'ION <br />¢4ANUPACIURI:;L) SI k~OTURE $~ATF~ FEE <br />MA~qUFAC[URED 'SfRUCfURE STAI B ~JRf.,~iARGE <br /> <br />IO1AL A~F~ED PE~ <br />PREVi OU~, RECEIPIS <br />'fHl~ RECEi Pl <br /> <br />QUANI[~Y AMOUNf <br /> <br /> $20,00 <br /> $g-~0 <br /> <br />PAYEE: <br /> <br />$2q1.10 <br />$2~_~o <br />$o.oo <br /> <br />BALANCE DUE $0.00 <br /> <br />INVOICE <br /> <br /> RE(.;S/Vb~ ~Y, ~ TIYPE: C~ECK ~: 0 <br /> THiS 1$ A VALID PERMIT :~ THIS PERMIT FEE COVER~ ONE INSPECTION AND ONE REINSPECTICN. ALL <br />~TA~R INSTALLATION. PLUD~ING, MECHANICAL, ANO ELECTRICAL CONNECTIONS ARE RE(,XJiRED TO BE CCMPLI <br />~.~UE~T FOR THE FIRST iNSPECTION. IF ANY OF THE ITEMS ARE INCOMPLETE, AN A~DIT[ONAL IN~PECTJ( <br />REQUIRE~. PERMIT I~ VALID FOR SIX MONTH~ ONLY. R~NENED FOR 6 NIONTH5 UP~N?RITTEN <br />E,~TENSIE]N, PRIOR TO THE EXPIRATION DATE OF THE PER, IT, IF CONSTI~JCTION FAIL.,.~ TO MEET ALL <br /> ~TATE LA~5 AND MARION COUNTY ~UiLDIN~ AND ZONiN~ ORDINANCE~, THiS PERMIT ~HALL BECC~E NULL <br /> <br />SEIBACKS: PR 10 L~ 10 R~ 10 RR 10 SP <br />REIVtARKS: MOBILE HUME PLACE~ENi ....... <br /> <br />PLANNING ACflON: <br />DONALD E, ~Y,)ODLgY, MARION QX3UNTY BUILDING OFFiCiAL / BY <br /> <br />FORM # MO 15-56 RE"/ ¢/90 OFFICE COPY <br /> <br /> <br />