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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 />of a registered builder, <br />TMe work will be performed by a registered builder, <br />Other <br /> <br />F~,~i~'¢il I)A T E: - 05/06'/94 TI'HEr' t 2:~'24:25 ............' f~,x LOTi ..... i C~T~6OR~; <br /> <br /> EPRE~AN~ JI~ .&. T.E~E~ ~5,~5=~ RESIDENT IAI,,, <br /> <br />~ ~8;J22 L. EVERH~N RD SE .;'Eb-~bitv;' ~ve~: ,~ <br /> <br />~ AUMSVILL, E OR 97325 ;MARION OOUNTY ~,NO <br />~:USE OF 8umLomwC: ~ ',NO O~ ~EO~OO~S: <br /> <br /> 5~2 N llrH I <br /> AUHSVILLE ~ SITE MUHBER: 94-816~2 <br /> PHONE: 747-15~ ~ VALUATION: <br /> <br /> ......................................... ~ ....................... ~ S ~.-4 48 , <br />t ....... L ..... , <br /> <br />TYPE= HANUFACTURED STRUCTURE <br />CONTRACTOR., NO. 46?05 <br /> PRUITT TRANSFER 'tHC <br />P 0 BOX 476 <br />LEBANOI% 77~55-0000 <br />PHONE: <br /> <br />PERNIT OR APPLICATION NO: 54618 <br /> <br /> ITEM <br />MAI,)UFACI'URED STRUCTURE PLACEMENT/CONNECTION <br />MAI,IUFACTIJRED STRUCTURE STATE FEE <br />HAN FAC EDU TUN STRUCTURE STATE SURCMARCE <br />MANUP~C'FURED STRUCTURE ZONING SU~CHARGE <br /> <br />TOTAL ASSESSED FEES <br />PREVIOUS RECEIPTS <br />TNIS RECEIPT <br /> <br />QUANTITY AMOUNT <br /> $182,.0~ <br /> $28.80 <br /> $9.10 <br /> $15.80 <br /> <br />$225.18 <br />$226.10 <br /> $~.00 <br /> <br />BALANCE'DUE $0.08 <br /> <br /> PAYEE: ~^^ ~F~) . RECEIPT. <br /> .................. £=~=%_.,,_~,.=====~=~====-~===:==:=== .............................................. <br /> :~ THIS IS A VALID PERMIT ~; THIS!'PERNIT FEE COVERS ONE INSPECTION AND ONE <br /> ~EINSPECTI8N. ALL ~L6CK[Hg~ STAIR INSTALLATION, PLUHBIN6~ NECNAHICAL. AND ELECTRICAL <br /> CONNECTIONS ARE REOUIRED TO BE cONFI~ETED UPON EEOUEST FOR THE FIRST INSPECTION. IF <br /> ANY OF THE ITEHS ARE INCO~PEETE__AN ADDITIONAL INS-'PECTIUN FEE NILL BE REQUIRED. <br /> PER~IT iS VALID FOR SIX 1fl3NTNB'OHLY. RENE~EB,FOR 6 MONTH8 UPON NRITTEN REQUEST FOR <br /> AH EXTENSION. PRIOR TO THE EXPIR~T~ON'D~TE GF,THEPERHIT. IF CONSTRUCTIGN FAILS TO <br /> ~EET ALL REOUIRF_.~EHTS OF STATE L~NS AND NAR!OHCOUNTY BUILDING AND ZONING ORDINANCES, <br />PL~NhlIHG ACT~OH: <br /> SETDA~KS: FR <br /> LS-10 <br /> RS"'IO <br /> RR"'~O <br /> <br /> REMARKS: MS:SS:S'I'D: SEE REVISED STTE PLAM DATED 5/2/94. EFFLUENT PUMP 'FO I'HE-~PROVED <br /> DRAtNFIELD SITES. <br /> DONALD E. WOODLEYN MARION COUNTY BUILD~NG OFFICIAL / BY <br /> <br />¢o~u # ac ts-s~ R~v. ~ OFFICE COPY <br /> <br /> <br />