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PHONE: 588-5147 8:00 - 4:30 <br /> 24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />Iarn performins work on a property I own or occupy. <br />I am aresistere¢ builder OR ) the authorized representative <br />of 8 r~.gistered"~ duirder, <br />The work will be pe formed by a regis ered bu Ider. <br />Other_ <br /> <br />MARION COUNTY BUILDING INSPECTION <br />SENATOR BLOG, NO. 225 / __~ <br />220 HIGH STREET NE ^ <br />SALEM, OREGON 97301 <br /> <br />SIGNATURE OF APPLICANT: <br /> <br />OWNER: gATE= :t0/1119;~ T'rME~ ld...~2=39 TsxLO~ CATEgOrY: <br /> SANTIAM HOME~ RE~DENT[AL <br />SITUS ADDRESS; CONSTRUCTION T~PE; OCCUPANCY: <br /> <br /> 2~8 ~ELLEVU[ DE 7B :,'80M~8+ c T~: 0~ OCCUPANT LOAn; <br /> AUMSVILLE OR 97325 , AUMSVILLE NO ~ <br /> <br />MANUFACTURE1) STRUCTURE <br /> <br /> M~LL, CREEK, ES. TATES <br />AGEHT: CRAIG LUCAS -- SANTIAM HOME8 <br />769-7744 ~ SITE NUMBER: <br />PHOHE: ', VALUATION: <br /> <br />55 , 84] 4628. ' SF NO NO <br /> <br />LOTr <br /> <br /> 70 <br />WIDTH: <br /> <br />TYPEA ~flNUFACTUIYgD STRUCTURE <br />CONTRACTOR, NO. 38238 <br />Daniel L, Carver <br />I1S7~ Mill Creek Rd <br />Aumsville, 97325-0000 <br />PNONE: 769-7?44 <br /> <br />PERHIT OR APPLICATION HO: 505~9 <br /> <br />ITEM <br />MANUFACTURED STRUCTURE PLACEMENT/CONNECTION <br />MANUFACTURED STRUCTURE STATE FEE <br />MANUFACTURED STRUCTURE STATE SURCHARGE <br /> <br />QUANTITY <br /> <br />AMOUNT <br /> $182.00 <br /> $20.08 <br /> $9.10 <br /> <br />TOTAL ASSESSEQ FEES <br />PREVIOUS RECEIPTS <br />THIS RECE%PT <br /> <br />$211.18 <br />$211.18 <br /> <br />BALANCE DUE $0,00 <br /> <br /> PAYEE: INVOICE <br /> RECEIVED BY: PB.................................. TYPE: CHECK ~: <br /> t* THIS IS A VALID PERMIT ** THIS PERMIT FEE COVERS ONE INSPECTION AND ONE <br /> REINSPECTIOfl. ALL DLOCKIflg. STAIR INSTAt. LRTIOH. PLUMMING~ ~EC~NICAL. AND ELECTRICAL <br /> COHNECTIONS ARE REOUIRED TO ~E COMPLETEDUPON'REOUESTFORTNE FIRST INSPECTION. IF <br /> ANY OF THE ~TEMS ARE INCOHPLETIE. A~ ADDITIONALINSPECTION FEE HILL BE REOUIRE~. <br /> PERHIT IS VALID FOR SIX HONTHS ONLY. RENE~EOFOR&HQNTHS UPON QRITTEN REQUEST FOR <br /> AH EXTENSION. PRIOR TO THE EXPIRATION DATE OF THE PERMIT. IF CONSTRUCTION FAILS TO <br /> NEET ~LL REQGIREflEHTS OF STATELAM5 ~HD HARIOfl COUMTY BUILDING AHD ZONING ORDINANCES, <br />PLANNING ACTION: <br /> SETBACKS: FR 11 <br /> LS-i~ <br /> RS-15 <br /> <br /> REMARKS. MFG HOME <br /> <br /> ~ONAI_~ E. WOO~LEY~ MARION COUNTY BUILDING OFFICIAL / BY <br /> <br />FORM # MC t~-¢6 R~V, 4/¢ OFFICE COPY <br /> <br /> <br />