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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG. NO. 2'~5 <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 />of a registered buiide¢. <br />The work will be performed by a registered builder, i <br />Other , ,, <br />I have read and aDree to the terms stated on the reverse side of <br /> <br /> 411 DURBIII ~1;; ~ ~7 ~ CONTRACT CITY; [U~B'. JOOCUPANTLOAD <br />AUMSV~i..LE ~ OR ~7325 ~- ~OMSVILLE <br /> <br />HAHUFA~TUREQ STRUCTURE ' ~ <br /> <br />1~59 N. 2ND Sl' <br />,JEFFERSON OR ~7352 : SITE HUMBER~ <br />FHONE. 3,.7 231o VALUATION. <br /> <br /> EPTH; ~ N~'. ~ IRREg. LOT'. CORNER: <br /> <br />TYPE: HANUFACTURED STRUCTURE <br />OOHYRACTOR, NO~ 1492~ <br /> COMH Woodb~zrn ]:'nc <br />285 S Pacific Hwy <br /> <br />Il'EH <br />MANUFACI'IJRr,'D STRUCTURE <br />NANIJFACTURED STRUCTURE <br />MANUFACTURED STRUCTURE <br /> <br />PERNIT UR APPLICATION NO~ ~648 <br /> <br />.F,'I~CEflENT/CD~ECT I OH <br />$5q1~ <br /> <br />PAYEE: <br />RECEIVED BY: CD ~: <br /> <br />*~ THIS IS A VALID <br />REIHSPECTION. ALL <br />CONHECTIONS ARE I <br />~ANY OF THE ITENS ARE <br />PERHIT IS VALID FOR SIX <br />AN EXTENSION, PRIOR TO THE <br />~"'rHE£T ALL REGUTREHENTS OF <br />PI.J~NNI NL~ <br /> <br />QUANTITY <br /> <br />AMOUNT <br /> $:L82. ~'~0 <br /> $20,, 00 <br /> $% 10 <br /> <br /> $211,, 10 <br /> $211.10 <br /> $0.00 <br /> <br />INVOICE <br />CHECK f: 0 <br /> <br />AND ONE <br /> <br /> AND ELECTRICAL <br /> iF <br />~UPON WRITTEN REQUEST FOR <br /> CONSTRUCTION FALLS TO <br /> AND ZONING ORDINANCES, <br /> SETBACKS: FR 25 <br /> L. 5-15 <br /> R0"15 <br /> RR-10 <br /> SP~ ......... <br /> <br />DONALD L.",, O[)ODL. EY,~ MARl:ON COON'FY BU: LDING OFFICIAL /'~Y .. <br /> <br />fORM # MC 1 ~.Se REV. 4/90 OF F IC E C0PY <br /> <br /> <br />