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MARION COUNTY BUILDING iNSPECTION <br />SENATOR BLDG, NO, 225 <br />220 HIGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br /> PHONE: 588-5147 8:00 - 4:30 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />I ~rn a registered builder OR ) the authorized representative <br />of a registered builder, <br /> <br />Other. <br /> <br /> I have read and agree to the terms stated an the reverse side of <br /> this document, <br />DATE.' 04/28/9Z 'r i~IE: <br /> <br />GREEN; 0CE <br /> <br />S~GNATURE OF APPLICANT; <br /> <br />CATE: <br /> <br />TAX LO~: ?05511? <br /> <br />CATEGORY: <br /> <br />R~',~iDENI'IAL <br /> <br /> ll~BZ I'HR~SH COOR'r <br />AURORA OR 97802 <br /> <br />CONSTRUCTION TYPE; <br /> <br />~ONTY ueB NO <br /> <br /> OCCUPANCY: <br /> <br />:OCCUPANT LOAD: <br /> <br />JSE OF BUILDING: <br /> MN~UFACI'UREO ;s'r RUCTURE <br /> <br />MAILING ADDRESS: <br /> 20 ~LKiNG WOOD OR <br /> LAI~E E.r-5~l~r.3r-J, OR <br /> PHONE: 97002 <br /> <br />SURD VISION <br /> <br /> NO OF BEDROOMS <br /> 3 <br /> <br />CENTURY 1',4E,~ NO ~, <br /> <br />SITE NUC4BER: 92-01583 <br /> VALUATION: <br /> <br />lq SECTION 33 [OWNSHIP 3~ ~AN(~E 1W ZONE MAP' <br /> ~5 AREA ~375. JNITE ~F ~REG. LOT NO cORNERNO <br /> <br />I~¢P~: B~ANOt~AI~ lURED STRUCTURE <br /> <br />~TI~AOTOR, NOi 7397'1 <br /> ~iN CONSTRUCTION <br />206 SE 4TH <br />'rROu'roALE, 97060-0000 <br />PHONE: 760-7736 <br /> <br />PERrqlr OR APPLICATION NO: ~9537 <br /> <br />r,~ANUFACTURED S'¢ROCTURE PLACF.~N'r/CT,.~NEC'FION <br />MANUFACTURED ~TRUCTURE STATE FEE <br />r~tJ~JFAC'rURED $'rF~UCTURE STA'rE~URC~ARGE <br />MANUFACTURED STRUCTURE ZONING SURCHARGE <br /> <br />fJ~JANTITY <br /> <br />$~82.00 <br />SZO.O0 <br /> $9.~o <br /> $~5.o0 <br /> <br />TO'rAL AS~EO FEES <br />PREW IOUS RECEIPTS <br />THiS RECEIPT <br /> <br />$226.10 <br />$226.10 <br /> <br /> ALL <br /> BALANCE 17,JE $0.00 <br /> <br /> PAYEE: RECE I PT <br /> RECEIVED BY: DM2 .......................................................... TYPEt CHECK ~t** 0 <br /> <br />~ THIS iS A VALID PEI~iT ~ THIS PEI~IlT FEE COVEi~ (~E iN.%°ECTION AND ONE REINSPECTION. <br />BLDCKING, 5TAIR INSTALLATI(~I~: PLUI~1811~, ~ECHANICAL, AND ELECTRICAL CONNECTIONS ARE RE.~IRED T <br />I~E CO~IPLETED UPON REd, JEST FOR ~ FIRST iI~SPECTION+ IF ~ OF THE iTEB~ ARE INCOMPLETE, AN <br />ADDITIONAL INSPECTION P-E'E I~IILL SE REqiJIRED. PEI~IIT IS VALID FOR SIX ~)NYf-~ ONLY. R~E~E~D P(~ <br />6 ~ONTH~ UI:~N WRITTEN Ri~QUE~T .FOR AN EXTENSION, PRIOR TO THE EXPIRATION DATE OF I~HE PEI~IIT. 4: <br />IF CON.~TRUCTION PAIL~ TO I~EET ALL RI~UiRE~,IENT~ OF ~TATE [.AW~ AND f~tARION COUNTY BUILDIN~ AND <br />ZONIN~ ORDINANCES, THI~ PER,liT ,~-IALL BEO3~IE NULL AND VOID+ <br /> <br />SETBACKS= FR 10 LS 5 RS 5 RR 20 SP <br /> RFJ4ARKS= ~P~'"'HOIvI~ -"'~iN'FAIN 8 FT SEPARAT[ONBE'rWEEN THE NANUFAC'f'U~HO~IEANDANY <br /> ACCESSORY STRUCTURE. <br /> PLANNING ACTION= <br /> DONALD E. WOODLE¥, MARION COUNTY ~UILDING OFFICIAL / BY ................................................................. <br /> <br /> OFFICECOPY <br />FORM ~ MC 15-56 REV, 4/SO <br /> <br /> <br />