Laserfiche WebLink
SENATOR BLDG, NO. 225 <br />220 HIGH STREET NE <br />SALEM, OREGON 97301 <br /> <br /> PHONE:588-5147 8:00- 4:80 <br /> 24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />I Am a registered builder OR ) the authorized representative ~IGNATURE OF APPLICANT;. _ = .................. <br />of ~ registered builder. <br />The work will be performed by a registered builder. <br />Other <br />I have read ahd agree to the terms stated on the reverse side Of DATE: <br />thi~ document. <br /> <br /> DEHU'T,~ [,Fh::.RY L, 157646-000 <br /> $1TU~ ADDRESS'. CONSTRUCTION TYPE; <br /> <br /> R <br /> <br /> AUH~V][LLEi :OR 9732~ ~RJ. ON COUNTY L IqL) <br /> <br /> MAILING AbDRESS: ~SU~DIVI$1ON: <br /> J, 29~ E~JA[_~ ~VE SE .............................................................................. <br /> SA t~M 973~2 ~ SITE NUH~ER: 94-~e~65 <br /> F'HONE: 585-4861 ~ VALUATION: <br /> <br />; : 7,, dsAC <br /> <br />~FYPE: 14AHUFACTUREI) STRUCTURE PERMIT OR APPLICATION <br /> <br /> Leisurelam~ Hob:i. le Flosses <br />PO Box 54~ <br />Sa !e~,~ 97S~4-~4~ <br />PHONE: 399-812~ <br /> <br /> ITEH <br />HANUFACTURED STRUCTURE :'LACEM~NT/CONN~ECTI)N <br />HANUFACTUREI) STRUCTURE ST:ATE .... <br /> <br />~IANUF'AC'I'URED ~TfRUCTURE ZO,~IF~ R~ARGE' ::~ <br />MANUFACTUF(ED STRUCTURE TUR~ <br />~ANUFAC't'UEED STRUCTURE TUR <br /> <br />PA'~EE: ~)EI"iiJ'¥',~ CHERYL <br />RECEIVED BY: Di"12 <br /> <br />~ THIS IS HOT A PERMIT. <br />FOLLOWINg MUST BE <br />THAT ALL NECESSARY <br /> <br />QtJAI,tT I 'fY AHOUN'f <br /> <br />$0.00 <br />$0.80 <br /> <br />RFC, EIPT 54608 <br />CHECK :~: 8,!}8 <br /> <br /> PROCESS WHERE THE <br />APPLICANT T8 ASSURE <br /> <br />FORM # MC I S-~6 REV, 4/90 OFFICE COPY <br /> <br /> <br />