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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 ~, reBi~tered builder OR the authorized representative <br />of a reBistered builder, <br />The work will be performed by a registere¢ builder, <br /> <br />TYPE: MANU,r-ACT~RE~ S?ROCTCJF~E PEP. MIT OR APPLICAT~M NO: <br />(',XlNI'RAC"'(~F4. N£t. 92549 <br /> <br />7911 $(;~LK[RREL. H).LI,. <br /> ,~7,, <br /> <br /> TOTAL AS~SSE9 FEES <br /> I'H )]$ RECEIPT <br /> <br />54427 <br /> <br />EUANTZTY AMOUNT <br /> <br /> $20,00 <br /> $9,,].~ <br /> <br />$2:L i. :[0 <br /> <br /> F'~ '~ ' :: ZNVOICE <br /> I,(!:Cl':;:Vf::~) ].% F': ........................... ;i ................................. ~;~;,.;,;,;,~__._ ....tyF,,,,, CHECK ¢,~ <br /> $* TH~S I8 A VALI~ PER~IT ~* TH~S ~PER~[? FEE COVERS ONE INSPECTION AN~ ONE <br /> CmDM~ECTIONS ARE REQUIRE~ TO BE COHPLETE~ UPON REQUEST FOR THE FIRST I~SPECTION. IF <br /> A~Y DF THE ITEMS ARE INCOMPLETE~ AN ABBITIONAL INSPECTION FEE WILL BE <br /> PERMIT ~S VALi~ FOR SIX HON~HS ONEY~ RENEWE~ FgR 6 MONTHS Upon ~RITTEN ~E~UE~T FOR <br /> A9 ~XTENSION. PRIOR TO THE EXPIRATION BATE OF THE PER~IT. IF CONSTRUCTION F~ILS TO <br /> <br />i':'LA?iU tN~ <br /> SETBACKS;~ FR ;k~ <br /> <br />CS[,!!4TY Ert. J]].,IXt:N6 OfF (~)Ai. / <br /> <br />RS- :{5 <br />F~R"":]. 5 <br /> <br />FORM # MO 15-58 REV. 4/90 OFFICE COPY <br /> <br /> <br />