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MARION COUNTY BUILDING INSPECTION <br />S~NATOIq BLDG. NO. 225 <br />220 HIGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br /> PHONE 588-5147 <br /> CODE-A-PHONE 4:30 RM. - 8:00 A.M. //~ ~ ~ ~_ ,~,"' . <br /> <br />I am a registered builder OH ( ) the authorized representative ~I~3NATURE OF APpLICAnT: ' <br /> <br />°W~RTE: 08/16/89 TIME; 10:04:2Ea <br /> <br />S~TUS AOORF, S$~ I VELEY, DELBEATE <br /> <br />14070 CESSNA ST <br />AURORA OR 97002 <br />USE OF BUILD~NG: <br /> <br />NE <br /> <br />, CONSTRUQTION TYPE; OCCUPANCY; <br />~ON~A~I~'~ ?t~i i OCCUPANT LOAD: <br /> <br />RESIDENTIAL <br /> <br />MA~iONCOUNTY Nb <br /> <br />NO OF BEDROOMS: <br /> <br />PO SOX 565 <br />NILSONVILLE OR 970?0 <br />PHONE: 682-5855 <br /> gLOCK; <br /> <br />SECTION: TQWNSHIP. <br /> <br /> SUNSET MOBILE PARK <br /> <br />SITE NUMBER: 4988 <br />~ANm~ALUATION:zoNE: MAP: <br /> <br />WIDTH: 5 DEPTH: 1 AREA: 0~ UNITS: 4S IRREGLOT: 1H ODRNEH: AR <br /> <br /> ?0 100 ?000.00 SF NO NO <br /> <br />TYPE: PLUPBZNG <br /> <br />PERMIT OR APPLICATION NO: 90181?4 <br /> <br />CONTRACTOR, NO. <br />HIVELEY. DELEiEATE <br />PO BOX 565 <br />HILSONVILLE OR 9?0?0 <br />PHONE: 582-5855 <br /> <br /> [TEN <br />MOBILE HOME SENER AND HATER CONNECTION <br />?LEET SURCHARGE -ZONE 8 <br />PLUfVl[BING STATE SURCHARGE: <br /> <br />QUANTITY AMOUNT <br /> 1 $25.00 <br /> <br /> $1.25 <br /> <br />':'~6~ALASSESSED,FEES <br /> PREVIOUS RECEIPTS <br /> THIS RECEIPT <br /> <br />$33.93 <br /> $o.oo <br />$33_93 <br /> <br />BALANCE DUE $0.00 <br /> <br /> AYEE HIVELEY, DEL~F~TE i :~ : : ~, RECEIPT NO: 19284 <br />RECEIVED BY: J~&~' __F~,'FZ.%-. ',';~ ,," ",~,' ,N,,~::,::':~YPE'~::CK ':CHECK ~: 231 <br /> <br />FOLLOWING MUST BE CONPLETED <br />ALL NECESSARY INFOI;~'~IATION <br /> <br />ILITY:~;THE::APPLIC.C~T TO A,~,?~JRE THAT <br /> <br />PLAN REVIEW: 8Y ........... <br /> <br />REMARKS: CONN R~7919 <br /> <br />OFFICE COPY <br /> <br /> <br />