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MARION COUNTY BUILDING INSPECTION <br /> <br />, , i FOR OFFICE USE ONLY1 <br />FOR HC U E.,ON y 220 ,- <br />Received by:...~g.,~,L~ Salem; OR 97~kQ_l city s~tha~ <br />Z~ing Validatio~:ff ~ s:~ ~-~?~ ~}~ ~]~ ~,... c~ rant: <br /> MANUFACTURED$~RUC~L C MENY ~ <br /> PER~TAP~I~ION . <br /> CO~TEALL SEC~ONS. 1T}~OUGH 4 ~ ~ ~ ~ ' ~i9 ~ ~ <br /> <br />1, Job De$c~ ~oa <br /> <br />Com~wml( ) New( ) ~placem~' ~)-/O,~ ( )Det~hed <br /> 'l Sq. F~ge: <br /> <br />2. Location of Installation ] <br /> <br />3. Contractor Information <br /> <br /> own, msid~ in, or will reside in th~ aoraplete8 atracture, <br /> ~Ind~rsta~d tha~ I muat ~s~r as a e~tme6~ ~nt~ ff ~ s~ <br /> wffi M my o~ g~c~al c~t~aor, <br /> <br /> h~ su~n~on, I w~ ~ oily subc~tmto~ ~t~ wi~ ~e tonsil <br />~y no~y Ma~on G~ty of ~e nme of ~ e~t. <br /> <br />(3) State Sureharsu <br /> <br />(4) Zoning Sumbaege (15,00 ff applicable) <br /> <br />is sold or offered f~r sale b~fo~ or uFon ~ompletlon. <br /> <br />( ~$m a reglst~r~d builder OR the authorized mpresentatlve of <br /> <br /> [M~AA~ss II~ MI~ ~g* ~4 Phone' <br /> <br />4: Fe~ Schedule , <br />A, (1) ~nufa~u~d Ho~e <br /> <br />(1) Mfg.'d Stmctu~ Storage Fee <br /> <br /> (2) ~vffg.'d Structure Storage Renewal <br /> <br />O) ZoMng Sun:barge (15 00 ff applicable) <br /> <br />TOTAL $, ,,~/~., d'~ E. Oth~ in~;,ectic~, not ~smd ~ MO,~ = __ <br /> ~ 40,~ ~r hour ~ h~r m~m) <br /> <br /> <br />