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MARION COUNTY BUILDING INSPECTION <br />S¢_.NA'FOR 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 />DATE: 01/29/92 <br /> <br /> SAN'I' [ AN HONES <br /> <br /> 135 SPRUCE Cl' <br />AUD&~VI LLE OR 9?325 <br /> <br />USE OF J~UJLDJN~i ......... <br /> <br />DATE[ <br /> <br />57706-0O0 <br /> <br />;AUf4SV I LLE i NO <br /> <br />CATEGORY: <br /> RESIOEN] JAL <br /> <br />MAIUNO ADDRESS. ~ANUFAC'f'~tRE~D s:rRuo'f~RE suamws~6~ <br /> <br />EVERGREEN rc/0BIL~ PARK <br /> <br />PHONE: SiTE NUIV~ER: 92-00454 <br /> VALUAllON: <br /> <br /> 22 25 85 2W RM <br /> 55~ 92' 5F Y~ NO <br /> <br />MAP: <br /> <br />TYPE: ~¢4UFACf'URED STRUCTURE <br /> <br />CON'T'RAC'I'OR, NO. 38238 <br />Danl~'l L Carver <br />11373 Mi"ll Creek Rd <br />Aumsvffl"le, 97325~0000 <br />F-~ONE: 769-7'/~ <br /> <br />PEFe~iT OR APPLICATION NO: <br /> <br />04ANUFACTURED STRUCTURE PLACB~IEN'F/CONNEC'rION <br />MiANUFACI'URED STRUCTURE S'I'A'I'~ FEE <br />~4ANUFACI'URED B'¥RUCTURE STATE SURCHARGE <br /> <br />TOTAL ASSESSED FE~ <br />PREVIOUS RECEIPT8 <br />THIS RECEIPT <br /> <br />38022 <br /> <br />Q:NLI~'I'I'I'Y Af~/JUNi <br /> $182_00 <br /> $20.00 <br /> <br />$211.10 <br />211.10 <br /> $o.oo <br /> <br />BALANCE DUE $0.00 <br /> <br />PAYEE: iNVOICE <br />RECEIVED BY: D~ TYPE~ CHECK =: O <br /> <br /> :~ THIS IS A VALID PER~[T ~ THIS PE~IT FEECOVERS ONE INSPECTION ,AND ONE REINSPECTION. ALL <br /> 8U3CKING, STAIR INSTALLATION, PLU~8ING, MECHANICAL; ANDELECTRiCAL CONNECTIONS ARE REQUIRED Ti <br /> BE COMPLETED UPON REQUEST FOR THE FIRST iN~PEI;TION. IF ANY OF THE ITEf4S ARE INCOf,IPLETE, AN <br /> ADDiTiONAL INSPECTioN FEE ~ILL BE RE~UIRED~PEI~,IIT IS VALID FOR SIX ~ONTHS ONLY. RE~E~/£D FOR <br /> § ~ONTHS UPON WRIT?~ ToR~M~ FOR AN ~XYS~.SION. PRIOR TO TH~ ~XPIRATION DATE O~ TH~ PERMIT. ,~ <br /> I~ ~YRUCTiON FAI~ i ~-L R~.;iR~YS OF STATE LA~NS AND ~ARION ODUNTY BUILDING AND <br />zONme E IT ALL VOID. <br /> <br />SETBACKS: FR 10 LS 15 RS ]5 RR:._15 SP ............... <br />REMARKS: IvioBz'LE HORE PLACEMENT <br /> <br />PLANNING ACTION: <br />[)ONALD E, ~2OOLEY, fflARION COUNTY BUILDING OFFICIAL <br /> <br />OFFICE COPY <br /> <br /> <br />