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MARION COUNTY BUILDING INSPECTION <br />SENATOR ~3LDG, ¢10. 225 <br />220 HIGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br /> PHONE 588-5147 <br />CODE-A-PHONE 4:30 P.M. - 8:00 A.M. <br /> <br /> I am a registered builder OR ( ) the authorized representative <br /> of ~ registered builder, <br /> <br />DATE: 07/06/8? TIME: 4:05:33m <br /> <br /> SELNES, ARNOLD & EVELYN <br /> <br />SITUS ADDRESS: <br /> <br /> 8'] 374-000 <br /> <br />CONSTRUCTION TYPE <br /> <br /> 9143 N. STAYTON RD <br />AU~SVILLE OR 97325 <br /> <br />USE O¢ BUILDING: <br /> <br /> SE CONTMACT DITY; UGS <br /> MC'. <br /> <br />MAILING ADDRESS: <br /> <br />SUBDIVISION: <br /> <br />CATEGORY: <br /> <br />ODCUPANCY; <br /> <br />OCCUPANT LOAD <br /> <br /> ~0 OF 8EOR00MS. <br /> <br /> PWON E: <br /> <br />gOT: BLOCK: <br /> <br />WlDTN: DEPTH; <br /> <br /> 1 9S 2iA <br />7. 00000 AC '~ <br /> <br />CONTRACTOR, NO- <br />SELNES, ,ARNOLD & EVELYN <br /> <br /> I T EM <br />MOSILE HOME FIRST NIDTH <br />M(~,',~,LE HOME ZONZNG SURCHARGS <br />~(~{'¢~LE HOME PLANS R~ FE~ <br />~L¢;~T SURCHARGE ~ZONE 3 <br />PIOBILE...H~4E STATE SURCHARGE <br /> <br />PAYEE: <br />RECEIVED BY: PB <br /> <br />~ THIS IS A VALID PEF~IIT * THI <br />CONSTRUCTION CEASES FOR A PER <br />REQI. IIRli~II~NT$ OF STATE LAI4S <br />SHALL 8E. CO~E NULL AND VOID- <br /> <br />AP~LICAT: <br /> <br />TOTAL ASSESSED FEES <br />PREVIOUS RECEIPTS <br />THIS RECEZPT <br /> <br />BALANCE DUE <br /> <br />MAi; <br /> <br />0UANTI~Y ,AMOUNT <br /> · , $35_00 <br /> Si,?5 <br /> <br /> $3..S4 <br /> <br />$0,00 <br /> <br /> ;NVOTCE NO: <br />TYPE: CHECK <br /> <br />5 FROM ITS IS.SUE DATE- iF <br /> FAILS TO MEET ALL <br /> ORDINANCES, THIS PSR~IT <br /> <br />30NALO E, NOODLEY, <br /> <br />OFFICE COPY <br /> <br /> <br />