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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: 58@-5147 8;00 - 4:30 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />of a registered builder, <br />The work will be performed by a registered builder. <br />Other <br /> <br />I have read 8nd agree to the terms stated on the reverse side of <br />this document, <br /> <br /> DATE: 12/03/92 TIME: 11:30:38 <br />OWNER: <br /> <br />GREEN~ JOE <br /> <br /> 11677 FALCON CT <br /> AUROR9 OR <br /> <br /> HANUFACTURED STRUCTURE <br /> <br />PO BOX 759 <br />PORTLgN9 97207 <br />PHONE: 68,5'~9685 <br /> <br />TAX LOT~ <br /> <br />97002 ;HARION COUNTY; NO <br /> <br />SUBDIVts{~N: <br /> <br /> SITE NUMBER: <br /> VALUATION: <br /> <br />CA'rEGORY: <br /> <br /> RESIDENTIAL <br />OCCUPANCY: <br /> <br />OCCUPANT LOAD: <br /> <br />LOT: BLOCK; SECTION: <br /> ~0 110 3F YES NO <br /> <br />TYPE: MANUFACTURED STRUCTURE <br />CONTRACTOR, NOv 73977 <br /> LAMAIN CONSTRUCTION <br />206 SE 4TH <br />TROU~OALE, 97060~0000 <br />PliON~: 76~--7756 <br /> <br />PERHIT OR APPLICATION NO: 4~51 <br /> <br />ITEH <br />HANUFACTUREO STRUCTURE PLACEHENT/CONNECTION <br />NAHUFACTUREO STRUCTURE STATE FEE <br />MANUFACTUREO STRUCTURE STATE SURCHARGE <br />MANUFACTUREO STRUCTURE ZONING SURCHARGE <br /> <br />TOTAL AS;SESSED FEES <br />PREVIOUS RECEIPTS <br />THIS RECEIPT <br /> <br />QUANTIFY AMOUNt <br /> $182.00 <br /> $20.00 <br /> $9.10 <br /> $15.00 <br /> <br />$226.~0 <br />$226.J, 0 <br /> $0.00 <br /> <br />BALANCE OUE $0.00 <br /> <br />PAYEE: RECEIPf <br /> <br /> RECEIVED BY: PB .................................... TYPE: CHECK b: 0 <br /> <br /> · ~ THIS IS A VALID PERMIT ~ THIS PERBIT FEE COB'ERS ONE INSPECTION AND ONE <br /> REINSPECTION. ALL BLOCKING, STAIR INSTALLATION, PLUMBING, MECHANICAL. AND ELECTRICAL <br /> CONNECTIONS ARE REQUIRED TO BE COMPLETED UPON REQUEST FOR THE FIRST INSPECTION~ IF <br /> ANY OF THE ITEHS ARE INCOMPLETE, AN ADOITIONAL INSPECTION FEE WILL BE REQUIRED~ <br /> PERMIT iS VALID FOR SIX HONTNS ONLY. RENEWED FOR 6 MONTHS UPON NRITTEN REQUEST FOR <br /> AN EXTENSION, PRIOR TO THE EXPIRATION DATE OF THE PERMIT. IF CONSTRUCTION FAILS TO <br /> NEET ALL REQUIREMENTS OF STATE LAWS AND MARION COUNTY BUILDING AND ZONING ORDINANCES, <br /> PLANNING ACTION: <br /> SETBACKS: FR_iO <br /> <br /> RR 12 <br /> SP <br /> REHARKS: NF6 HOHE. SEE FguNDATIgN ORAHINBS, CALCS & SOILS REPORT FOR SPECIAL SiTE <br /> INSTALLATION REQUIREMENTS AS HgNUF~ HOME HILL BE INSTALLEO ON FILL. <br />¢~ONALD E. ~OOOLEY, MARION COUNTY 8UILDZN6 OFFICIAL / BY ........................................... <br /> <br />OFFICE COPY <br /> <br /> <br />