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MARION COUNTY BUILDING INSPECTIONi <br />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 /> The work will be performed by a registered builder, <br /> Other <br /> <br /> ,DATE: 0,¢,./1'!'/$2 TINE: 10:37:1' <br /> ORR, LARRY <br />SITUS 'ADdREss. ' .... <br /> <br /> 330 EVERGREEN OR <br />AUI'fl.SV 1' L LE OR 9'1 ~.25 <br /> <br /> ...... 1'4.~NU FAC'FU REO -,$'I'RIJC'f'U RE <br />MAILING ADDRESS: <br /> <br /> TAX LOT <br /> <br /> GONSTRUCTION TYPE <br /> <br />3~CONTRACT CITY; <br /> AUM~V i LEE <br /> <br />57705-000 <br /> <br /> NO <br />EVERGREEN ESl'Al'ES <br /> <br /> CATEGORY; <br /> RES I D~N1 1 AL <br /> OCCUPANCY: <br /> R-3 <br />[0~cUPANT <br /> <br /> iN0 0F 8EDR00MS: <br /> <br /> SITE NUf~BER: 92-01534 VALUA'T' I ON .* <br />LOT: iat. oOK: '"' ~C~lO N'. TOWNSHI~ ....... I~,1~ 6 ~ .......... ~ohEF ...... M~P: ' <br /> 38 <br /> 25 8S 2W ~M <br />WIOTH; 'DE~H: AREA UNITS RREG LOT: CORNER'. <br /> 55 85: 4675_ SF N(~ NO <br /> <br />TYPE: MANUFACTURED $'~'RUc'FURE PERMIT OR APPLICATION NO.* 9039443 <br /> <br />CONTRACTOR NO. 38238 <br />O,¢~nie" L C~r'ver, <br />11373 M'~-l-J Creek Rd <br />Auto. vi '/'le, 97325~0000 <br />PHONE: ?'89-??44 <br /> <br />IViANUFAC'f'UREO STRUCTURE PLACEMENT/CONNECTION <br />MANUFACTURED 8'rRUCTURE STATE FEE <br />MANUFACTURED S'f'F,~UC'fURE STATE ~URCHARGE <br /> <br />QUAN 1' i 'rY <br /> <br />TOTAL ASSE~ED FEES <br />PRF_'V iO"JS RECEIPTS <br />THIS RECEIPT <br /> <br />$20.00 <br />$9-~0 <br /> <br />$211.t0 <br /> $0.00 <br />$211.10 <br /> <br />BALANCE f3JE $0.00 <br /> <br />PAYEE: CRAIG LUCA~ iNVOiCE 41487 <br />RECEIVED BY: PS .................................................................................................... TYPE: iN CHECK ~: 0 <br />~ THIS IS NOT A PEI~NIlT. THIS APPLICATION MUST GO THROUGH A R~Vi~{~ PRC~ESS ~ERE THE FOLL~Ih <br />~T BE,~PLETED. iT iS THE R~SiSiLITY OF THE APPLi~T TO ~RE THAT ALL NEC~RY <br />IN~TI~ H~ BE~ P~ViDED. <br /> <br />SEPT~C: BY ................................................ DATE ......................................................... CiTY JURISOIOTiON: BY DATE <br />ZONING: BY DATE SE'f'SACK~: FR lO L8 15 R~ 15 RR 10 SP <br />REMARKS: IViO~i'EE""~O51E PLACEmEnT ................................. <br /> <br />PLANNING ACTION: <br /> <br /> OFFICECOPY <br />FORM ~ MC 1 ~-~6 R~V, 4~ <br /> <br /> <br />