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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: 68847904 <br /> <br />Other. <br /> DATE: <br /> <br />I have read and agree to the terms stated on the reverse side of <br />this document. <br /> <br /> OATE;; <br />OWNER; <br /> GREEN, JOE <br />SfTUS ADDRESS~ <br /> <br />12/03/92 TIME: 11:41:09 <br /> , TAX LOT; ~ATEGORY: <br /> RESIDENTIAL <br /> <br /> R-3 <br /> NE 33 ' CONTn*CT C'fY'. .... l'Oe~; 'OOOUPANT LO^O: <br /> OR 97002 ~MARION COUNTY i NO <br /> <br /> 11687 FALCON CT <br />AURORA <br /> <br />MANUFACTUREO STRUCTURE <br /> <br /> CENTURY MEADOWS <br />PO BOX 759 <br />PORTLAND 97207 SITE NUMBER: 92-03754 <br />PHONE: 685~9685 VALUATION: <br /> <br /> BLOCK: SECTION: ; ~6~1~ i ~N~E: ~0NE: MAP; <br /> <br />LOT: <br /> <br />WIDTH: <br /> <br />4O <br /> <br />ilO SF ~ YES NO <br /> <br />TYPE: MANUFACTURED STRUCTURE <br />CONTRACTOR, NO. 73977 <br /> LAMAIN CONSTRUCTION <br />206 SE 4TH <br />TROUTOALE, 97060-0000 <br />RHONE: 760-7736 <br /> <br />PERMIT OR APPLICATION NO: 45553 <br /> <br />ITEM <br />MANUFACTUREO STRUCTURE PLACEMENT/CONNECTION <br />NANUFACTUREO STRUCTURE STATE FEE <br />MANUFACTURED STRUCTURE STATE SURCHARGE <br />MANUFACTUREO STRUCTURE ZONING SURCHARGE <br /> <br />TOTAL ASSESSEO FEES <br />PREVIOUS RECEIPTS <br />THIS RECEIPT <br /> <br />QUANTITY AMOUNT <br /> $182.00 <br /> $20.00 <br /> $9~10 <br /> $15.00 <br /> <br />PAYEE: <br /> <br />$226.10 <br />$226.10 <br /> $0.00 <br /> <br />BALANCE DUE $0.00 <br /> <br />RECEIPT <br /> <br /> RECEIVED BY: PB TYPE: CHECK ~: 0 <br /> <br /> · * THIS IS A VALID PERMIT *z THIS PERMIT FEE COVERS ONE INSPECTION AND ONE <br /> REINSPECTiON. ALL BLOCKING, STAIR INSTALLATION, PLUMBING, MECHANICAL, AND ELECTRICAL <br /> CONNECTIONS ARE REGUIRED TO BE COMPLETEO UPON REQUEST FOR THE FIRST INSPECTION. IF <br /> ANY OF THE ITEMS ARE INCOMPLETE, AN ADDITIONAL INSPECTION FEE WILL BE REQUIRED. <br /> PERMIT IS VALID FOR SIX MONTHS ONLY. RENEWED FOR 6 MONTHS UPON WRITTEN REQUEST FOR <br /> AN EXTENSION, PRIOR TO THE EXPIRATION DATE OF THE PERMIT~ IF CONSTRUCTION FAILS TO <br /> MEET ALL REGUIREMENTS OF STATE LAWS AND MARION COUNTY BUILDING AND ZONING ORDINANCES, <br />PLANNING ACTION; <br /> SETBACKS:FA_lO <br /> LS 5 <br /> <br /> RR 14 <br /> BP- <br /> REMARKS: HFS NOME ~ SEE FOUNDATION DRAWINGS AND SOILS REPORT FOR SITE INSTAllatION <br /> REQUIREMENTS AS MANUFACTURED HOME WILL. BE INSTALLED ON FILL A& <br />DONALD E. WOOOLEY, MARION COUNTY BUILDING OFFICIAL / BY ..................... ~ <br /> <br /> '~ OFFICE COFY <br />FORM # MC 15,56 REV. 4/90 <br /> <br /> <br />