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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 />The work win be performed by 8 registered builder. <br />Other <br /> <br />th~s document, <br />DATE: 10/O9/.~2 T!HE:, i ~,:~ [_DY; <br /> ~ EES~DENT[~L <br />ROSE, FRANKLIN <br /> <br /> ~UMSVILLE OR 97~25 ~H~RION COUNTY~ NO <br /> <br />MANUFACTURED STRUCTURE <br /> <br />5210 RIVER ROAD N ~lO00 <br />KEIZER 97503 OFFICE $95-3624 X-$50 <br />PHONE: 590-9~53 <br /> <br />SiTE NUMBER: 92-05199 <br />VALUATION: <br /> <br />'LOT: / ¢,1.~: ................ ~'~¥ '~i .......... {TOWNSHIP: I. RANGE; .[ ZONE; <br /> <br />TYPE: HANUFACTURED STRUCTURE PERMIT OR APPLICATION NO: <br />CONTRACTOR, NO. <br /> Le~suPeland Mobile Homes Inc <br />PO Box 5400 <br />Salem, 97~04~0400 <br />PHONE~ 299-0127 <br /> <br /> ITEM <br />MANUFACTURED STRUCTURE PLaCEMENT/CONNECTION <br />HANUFACTUREO STRUCTURE STATE FEE <br />MANUFACTURED STRUCTURE S~ATE SURCHARGE <br />MANUFACTURED STRUCTURE ZONING SURC'HARGE <br />MANUFACTURED STRUCTURE TURNPI'KE D/W BUILDING:INSPECTION <br />MANUFACTURED STRUCTURE TURNPiI:~E D/~ PUBLIC ~ORKS:.:, = <br /> TOTAL ASSESSEU FEES <br /> <br />PAYEE: <br /> <br />42599 <br /> <br />QUANTITY AMOUNT <br /> $182.00 <br /> $20.00 <br /> <br /> $15.00 <br /> $16.00 <br /> <br />$245.10 <br />$245.~0 <br /> <br />$0.00 <br /> <br />RECEIPT <br />CHECK ~: 0 <br /> <br />SETBACKS: FR 20 <br /> LS-IO <br /> RS~IO <br /> RRZ~O <br /> <br />OFFICE COPY <br /> <br /> REMARKS-__ <br /> <br />DONALD E. NOOOLEY, MARION COUNTY BUILDING OFFICIAL / BY <br /> <br />PLANNING ACTION= <br /> <br />· ~ THIS iS A VBLID PERMIT ~ THIS. PERMIT FEE'OOVERS ONE INSPECTION AND ONE <br />REINSPECTION. ALL BLOCKING,:'S~AI:R::iIRSTALEAT:iON, PLUflBING, HECHANICAL. AND ELECTRICAL <br />CONNECTIONS &RE REQUIRED;TO:BE':CONPLETED.UPON:'REQUEsTFOR::THE FIRST iNSPECTION. IF <br />ANY OF THE iTEMS ARE INCOMPLEIE, AN:~ooITiONAE INSPECTION FEE WILL BE REQUIRED. <br />PERMIT IS VALID FOR SIX MO~TN~::ONLY~: R'ENEWED FOR16:MONTHS UPON WRITTEN REQUEST FOR <br />AN EXTENSION. PRIOR TO THE EX~IRATION:OATE:OFiTME:::PERMIT~ IF CONSTRUCTION FAILS TO <br />MEET ALL REQUIREMENTS OF STATE LAWS AND MARION cOUNTY BUILDING AND ZONING ORDINANCES, <br /> <br /> <br />