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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 will be performed by a registered builder. <br />Other <br /> <br />~SITU$ ADDRESS= i CONSTRUCTION TYPE; i OCCUPANCY= <br />I ' <br /> <br />i J.~;~'~,! !.I-'-'V~!;~A!~J I:~.~ ~ ; CONTRACT CITY; UG8; ,OCCUPANT ~oAD'; <br /> <br />~USE OF ~UILDING; ......................................... [ ~ <br /> <br /> ALb~SVZ,,.L,E' ~ ~ SITE NU~ER: 74-816~2 <br /> <br /> ¢[ ! ~ ~j I 8c ............. ,....~g ........................ AR L48 <br />~i5~; ............... !'~¢~ .............. T'~ O~'~]:.. .... : ~R~ LO~ ~ COR~: <br /> . ~ ~ ~ ........ ~., _ __A~-_ ...... , h~o .........h~0 .......... <br /> <br />TYPE; MANUFACTUREI) STRUCTURE pERt4IT OR APPLICATION NO: <br /> <br />F' () ~0X 476 <br /> <br />HANUFAC'f'URE~ STRUCTURE ST(~TE FEE <br />itANI,JFACT[JRED S'FRUC'T'UF~E STOl,, <br />HAt,[UFA[:'fURE~,) STRI;C'[Ui~E Z~N~N¢,SURCFAR~E <br /> <br /> IOT~L ~So~;S,,I;,~ FEES <br /> PR[-V.I, Od,~. RE, bEZF fg <br /> <br />9054&18 <br /> <br />QUANTITY <br /> <br />AH(]UNT <br /> <br />FOLLOWZNG MUST ~E RESPONSIBILITY OF TBE APPLICANT TO ASSURE <br />'mAT ALL NECEGSAEY INFO~HATI~N HAS <br /> <br />FORM # M~ l~-~e Rsv, 4~o OF FIC E COPY <br /> <br /> <br />