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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 />I am a registered builder OR { ) the authorized representative <br /> <br />The work will be perlormed by a registered builder. <br />Other <br /> <br /> HANUF~CT4]RE;D,.~"'~ ......... .JC ~. <br /> i NILL CREEK ESTATES <br />: PHOI~E~ 926--,/)7~t~ ~ VAL, UAT];ON ~ <br /> <br /> ...................... ~ .........................J ........................J .......................... '. <br /> <br />NO 0¢ BEDEOOM5 <br /> 3 <br /> <br />TYPE: MANUFACTURE9 STRUCTURE PERMIT OR APPLICATION NO.: <br />~am~pl J_. Csrver <br /> <br />PHONE: 769-,,7744 <br /> <br /> ITEH <br />NANUFACTURED STRUCTURE PI..ACEHE~F[/CON~ECT:[ON <br />NANUF'ACTURED STRL[C'FURE; STATE <br />HANUFAC?'L~RI~]) ~')'RUCTURE STATE: <br /> <br /> : TOTAL AS(~ESi~E~ FEES <br /> PRE ¢,),8US RECEZPTS <br /> i THZS RECEZPT <br /> <br />PAYEE;: : : <br /> <br />QUANT I'FY AH[JUN T <br /> $182., 00 <br /> <br /> $211.18 <br /> $2~ t. 18 <br /> <br />INVOICE ~} <br />CHECK ~: ~ <br /> <br />** THIS iS A VALID PERMIT **THIS PERMIT FEE COVERS ONE INSPECTION AND ONE <br />~EINSPECTION. ALL BLOCKING~ STAIR INSTALLATION, PLUi"tBING, ~ECHANICAL.~ AND ELECTRICAL <br />CONNECTIONS ARE REOUIRE~ TO BE' COMPLETE9 UPON REQUEST ~OR THE FIRST INSPECTION. IF <br />ANY, OF THE ITEMS ARE INCO~PLETE¢ :AN:,ADQITI8NAE IflSPECT~ON FEE OILL BE REQUIRE~- <br />AN EXTENSION~ PRIOR TO T~E EXPIR~T'ION:~ATE OF THE PERMIT, IF CONSTRUCTION FAILS TO <br /> SE1BAL. kS,, FR 18 <br /> <br />LS-"15 <br /> <br />R R '- :L ,8 <br />SP"- <br /> <br />FORM # MC 15-56 REV, 4/90 OFFICE COPY <br /> <br /> <br />