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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 reglslered builder. <br /> <br /> STRAWN,, FAY W, RES~DENT]:AL <br />: ~l'ruS ADDRESS~ OCCUPANCY: <br /> <br /> 6729 6722 PETER RD SE ,~GNSRA~TCITg: U~: ;OCCUPANT LOAD: <br /> ~tJMSVILLE O~ ~7~2~ ' MgR~ON CSUNT~ NO <br /> <br /> MANUFACI'URE~ sTRucTURE i 2 <br /> <br /> SAME '"' ' ..................................... <br /> ; SITE NUHBER: 74-~12~5 <br /> PNOIIE: 749,,-2858 VALUATION: <br /> <br />, :L9 8S [, 1H ........ EFU 48 <br />,, 10. AC L NO NO <br /> <br />TYPE: HAHUFACTURED STRUCTURE <br />CONTRACTOR. NO. 4&,.05 <br /> PRUII'T TRc]HsF'ER INC <br />P 0 BOX 476 <br />L, EBA N(.ll1,~ 97~55-0000 <br />PHONE: <br /> <br />PERHIT OR APPLICATION NO: 9853849 <br /> <br />ITE~ <br />MANUFACTURED STRUCTURE PLACEfiENT/CONHECTION <br />NANUFAC'IURED STRUCTURE STATE FEE <br />HANUFACI'U~ED ST~UCI'IJRE STATE SURCHARGE <br />~ANUFADTURED STRUCTURE ZONING SURCHARGE <br /> <br />TOTAL ASSESSED FEES <br />PREVIOtJ8 RECEIPTS <br />TNIS RECEIPT <br /> <br />QUANTITY AMOUNT <br /> $182.00 <br /> $20.00 <br /> <br /> $15.00 <br /> <br />$ ,= .,.~'f', · 10 <br /> $0,00 <br />$226. :1.0 <br /> <br />BALANCE DUE $0.00 <br /> <br />PAYEE: STRAWN. FAY W. RECEIPT 56~1& <br />RECEIVED BY: RB ............................................... TYPE: CK CHECK ,~: 25~9 <br /> <br />~ THIS IS NOT A PERNIT. THIS APPLICATIOH HUST GO ll. IRg~GH A REVIEW PROCESS WHERE THE <br />FOLLO~IN~ HUST BE COHPLETE~. IT IS THE RESPONS[B[LITY OF THE APPLICAHT TO ASSURE <br />THAT ALL NECESSARY INFORNATION HAS BEENPROYZDED. <br /> <br />SETBACKS: FR ,t.. 0 <br /> L.S'-I'"~"O <br /> RS?-~ ...... <br /> <br />FORM # MC 18,56 REV. 4/90 OFFICE COPY <br /> <br /> <br />