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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 />~ am performing WOrk on a property I own or occupy. <br />I Am 8 registered builder OR the authorized representative <br /> of a registered builder. <br />Tile work will be performed by a registered builder. <br />Other_ <br /> <br />SI(~NATURE OF APPLICANT: <br /> OATE; <br /> <br />OWNER: I)ATE: <br /> BLAZER INDUSTRIES <br /> SITUS ADDRESS'. <br /> <br />TIHE: 1,_.09. <br /> <br /> 945 OLNEY <br /> AUMSV ]].J...E OR <br /> <br />[JSE OF BUILDINGI <br /> <br /> MANUEACTURE9 STRUCTURE <br /> <br />97025 <br /> <br /> 57866-.080 <br />CONSTRUCTION ~YPE: <br /> <br />AUflSVi[LLE HO <br /> <br />CATEGORY: <br /> <br /> COHHERCIAL <br /> <br /> B-2 <br />OCCUI~AN'f LOAD'. <br /> <br />SUBDIVISION: <br /> <br />LOT: <br /> <br />WIDTHI <br /> <br />PO BOX ,~,~5 <br />SILVERTOH OR 9738:1. <br />F HONE,, <br /> <br />BLOCK: <br /> <br />OEPTN; <br /> <br /> 460 <br /> <br />:SECTION: <br /> <br /> 24 80 <br /> 44~960. SF <br /> <br />SITE NUMBER: <br />VALUATION: <br /> <br /> 2W <br /> NO YES <br /> <br />MAP: <br /> <br />TYPE= MANUFACTURE~) STRUCTURE <br />[,r][,ITRA[,TOE,~ Ii0. <br />BLAZER INDUSTRIES <br />P6 BOX <br />S'.[I_VERTON OR 97~81 <br />PHONE: <br /> <br />PERMIT OR APPLICATION NO: 47839 <br /> <br /> I TIEN <br />HANUFA[;TURED STRUCTURE F'LACEHENT/COI'II,IECTION <br />MANUFACTURED STRUCTURE STATE FEE <br />MANUFACTURED STRUCTURE: STATIE SURCHARGE <br /> <br />PAYI,'-:E: <br /> <br />TOTAL AooEoSEI) FEES <br />F'REVIOU:B RECEIPTS <br />THIS REBEIPT <br /> <br />QUAN'rITY <br /> <br />AMOUHT <br /> $182,,06 <br /> $20.00 <br /> <br />$211. :16 <br />$211 ,, 16 <br /> $0.06 <br /> <br />BALANCE DUE $0.~6 <br /> <br />INVOICE <br /> <br /> RECE:[VE~) BY: F'B ............................................................................. TYPE: CHECK ~: 6 <br /> <br /> *~ THIS IS A VALID PERMIT ~* THIS PERHIT FEE COVERS ONE INSPECTION AN9 ONE <br /> REINSPECTIBN. ALL BLOCKING, STAIR INSTALLATiONi PLUMBINC~ MECHANICAL. AN~ ELECTRICAL <br /> CONNECTIONS ARE REQOIREB TO BE COMPLETED UPON REQUEST FOR THE FIRST INSPECTION. IF <br /> ANY OF THE ITEMS ARE INCQMPLETE. AN A~DITIONAL INSPECTION FEE WILL BE REOUiRE~. <br /> PERMIT IS VALID FQR SIX MQNTUS ONLY. RENEWEB FIBR 6 MONTHS UPBN WRITTEN REQUEST FOR <br /> AM EXTENSION. PRIOR TQ TNE EXPIRATION DATE OF THE PERMIT. IF CONSTRU6TIQM FAILS TO <br /> MEET ALL REQUIREMENTS OF STATE LAWS AND MARION COUNTY BUILDING AND ZONING ORQIMANCES, <br />PI,.ANNIN~ ACTION: <br /> SETBACKS: FR 6 <br /> LS'"'6 <br /> RS"0 <br /> RR""O <br /> SP- <br /> REHARKS: REI,.O6~TE NS OFFZCE ON PROPERTY ....... <br /> <br /> D~Nh[_I) E. ~OI)[,.EY~ ~hRI6N C6~N'f¥ BUiI,.DIH[ 6FE]iCIAL / BY ....................................................................... <br /> <br /> OFFICE COPY <br />FORM # MC 15-~6 REV, 4/90 <br /> <br /> <br />