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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 />of ~ Pegbtered builder, <br />The work will be performed by a Pegistered builder, <br />Other <br /> <br /> DA'rEt 5107/82 <br /> OWNER: <br /> rflAR'I'iNEZ. <br />~ITUS ADDRESS: <br /> <br />PAUL <br /> <br />57Y06-000 <br /> NO <br /> <br /> 255 YEW s'r :~0CONfRACT CITY; <br />AUMSVI LLE OR 9?325 <br /> AUffl~V~LLL~2 . <br /> <br />MANUFACTURED STRUCTURE <br /> <br />484? ADOBE $'r SE <br />SALE~ OR 97301 <br />PHONE; 263-1383 <br /> <br />CATEGORY'. <br /> ;tESI DEN I iAI <br />OCCUPANCY. <br /> <br />OC;C;,U PA N T LOAD' <br /> <br />EVERGREEN MOB[Lb PARK <br /> <br />SITE NUMBER.+ 92-01558 <br /> vALUAT I ON .* <br /> ZONE: <br /> <br /> YES NO <br /> <br />MAP <br /> <br />TYPE; NANUFAC'FURED STRUCTURE <br /> <br />CON'I'RAC'I'OR, NO. <br />r, tARTINEZ, PAUL <br />484? ADOBE S'I' SE <br />SALF.~I OR 97301 <br />PHONE: 363-1383 <br /> <br />PERMIT OR APPLiCATiON NO: <br /> <br />feCN'NUFAC'I'UREO STRUCTURE PLACF_~IEN'f/CONNEC'F[ON <br />MANUFACTURED STRUCTURE STATE FEE <br />~UPAC'FURED s'r~C'rURE STATE ~A~E <br /> <br />TOTAL ~E~ED FEES <br />PRE¥[OU$ RECEIPTS <br />'T'HiS RECEIPT <br /> <br />BALANCE DUE <br /> <br />39&94 <br /> <br />QUANTITY <br /> <br />A~OUN'T' <br /> <br /> $20.00 <br /> $9.~0 <br /> <br />$211.10 <br /> $0.00 <br /> <br />$0_00 <br /> <br /> PAYEE= INVOICE 0 <br /> RECEIVEO BY~ PB TYPE: CHECK ~: 0 <br /> <br />~ TH~S IS A VALID PERi, IT ~< THIS PERMIT FEE COVERS ONE iNSPECTioN AND ONE REINSPECTION. ALL <br />BLOCKING, STAIR INSTALl_AT[ON, PL.UfflBIN6, MECHANICAL, ~N~D ELE~CTRiCAL CONNECTIONS ARE RE.(;~.IJREO T <br />GE COMPLETED UPON REqME~T FORTHE FIR~STINSPECTION. IF ANy OF THE ITEMS ARE iNCOMPLeTE, AN <br />ADDiTiONAL INSPECTION FEEHILL BE REI~JIREO. PER~IT IS VALID FOR SIX ~IONTHS ONLY. RE~E~EO FOG <br />B MONTHS UPON NRITTEN RE(~JEST POR AN EXTENSiON, PRIOR TO THE EXPIRATION DATE OF THE PE~IT. <br />IF CONSTRUCTION FAIL~ TO MEET ALL RE~UIRENENTS OF STATE LAN~ AND MARION COUNTY BUILDING AND <br />ZONING ORDINANCES, THIS PE~IiT ~HALL BECOf4E NULL ~¢4D VOID. <br /> <br />S~'[BA.C.'.~S: ~iR~,A~,,',~ L8 PER R~ SiTE RR PLAN <br />RP.}4AR~,~: f4OB~'g,E HOME PLACEIVlEN3 ................. <br /> <br /> PLANNING Ac'r ION: <br />,DONALD E. NOODLBY. MARioN COUNTY BUILDING OP'P'[C[AL / BY <br /> <br /> OFFICE COPY <br />FORM # MC 1 ~-~6 REV. 4/90 <br /> <br /> <br />