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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 />I am perfor,.m, ing work on a property I own or occupy. <br />I am 8 rogimered builrer OR the authorized representative <br />of 8 registered builder, ¢ , <br />The work will be performed by a regirtcred builder. <br />Other__ <br /> <br />SIGNATURE OF APPLICANT: <br /> CATE: <br /> <br />owr~i~'f'E: 10/31/91 TINE; 14:31;46 'rAXLO¥: <br /> F~L~ER, ~JL 57706~000 <br />S~TUS AO~R~SS: CONSTRUCTION TYPE: <br /> <br /> ~35 YEW CT ~2CONTRACT CITY: UGB; <br /> AU~Vi LLE OR 97325 : <br /> ~V~ LLE NO <br />USE OF BUILDING: <br /> <br />CATEGORY: <br /> RES i DENT i AL <br />OCCUPANCY: <br /> <br />OCCUPANT LOAD: <br /> <br />NO 0¢ rEOR00M$ <br /> <br />MAJJJN~ ~OJ)~ESS: IV~ANUFACTURED ~,'f'~tJO'I"URE SUBDIVISION: <br /> <br />PO BOX 84 <br />ALBANY OR 97321 <br />PHONE: 393-004t\ <br /> <br />LOf: BLOCK: <br /> <br />EVERGREEN t',IOBILE ESTATES <br /> <br />~I]'E NUNBER: 14'?' 1,~ <br />VALUA'F I ON: <br />RANGE: ZONEI <br /> <br />MAP: <br /> <br />32 <br /> <br /> 551 <br /> <br /> AREA: UNITS: IRRE~ LO)': CORNER: <br />80 ~F Y~ NO <br /> <br />TYPE: NANUFACTURED STRUCTURE <br /> <br />CONI'RACI'OR, NO+ 38238 <br />Daniel L Car~r <br />11373 Mi]'l Creek Rd <br />Aurnsvf'l'le, 97325-0000 <br />PHONE: ?69-?744 <br /> <br />PER~iT OR APPLiCATiON NO: 36428 <br /> <br />I~NUFACTURED S'f'RUC'fURE PLACENPJNT/CONNEC'f'iON <br />NANUFACTURED STRUCTURE STATE FEE <br />1~'¢¢4UFAC'f'URED ~'rr,~Jc-ruRE STATE SURCHArgE <br /> <br />TOTAL ASSETS~ED FEES <br />PREWIOUS RECEIPTS <br />THIS RECEIPT <br /> <br />0UANflTY ANOUNT <br /> $~82.00 <br /> $20.00 <br /> $9.~0 <br /> <br />$0_00 <br /> <br />BALANCE CUE $O.OO <br /> <br />PAYEE: INVOICE <br />RECEIVED BY: 0~2 TYPE; CHECK ~: 0 <br /> <br /> '~ THIS IS A VALID PER,liT ~ THiS PER~41T FEE COVER~ ONE INSPECTION AND ONE REINSPECTION. ALL <br /> ~.T. AiR_iNS__TA_LLATION, PLUFtBING, MEQ4ANiCAL. AND ELECTRICAL CONNECTIONS ARE REqUiRED TO BE OC~IPL <br /> h:~Jk~Ju..'st I-~JR THE FIleT iNSPECTiON. IF ANY OF THE ITE~E~ ARE INCOMPLETE, AN ADDITIONAL INSPECTI <br /> 8E REqUiRED. PE~IT I$ VALID FOR $1X ~ONTH~ ONLY. RENE~ED FOR 6 ~ONTHS UI:K3N WRITTEN REQUEST, <br /> ~TENSION, PRIOR TO THE EXPIRATION DATE OF ]HE PE~IT~ iF CC%'~.~,TRUCTION FAILS TO t~EE'f ALL R~ <br />OF STATE LA~ AND ~iARION COUNTY BUILDING AND ZONING ORDINANCES5, THIS PE~IT ,SHALL BECO~IE NULL <br /> <br />SE'T'BACKS: F'R 10 g$ 10 RS 10 RR,.,.10 SP <br />REMARK.S; MOBILE HONE PLACEREN'T .............. <br /> <br />PLANNING ACTION: <br />DONALD E. NOODLEY, Fe~ARION t'f,i~JN'I'Y BUILDING OFFiCiAL / BY <br /> <br />OFFICE COPY <br /> <br /> <br />