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STATE OF OREGON <br /> BUILDING CODES AGENCY <br />MANUFACTURED STRUCTtJRE~ AND PARKS eECTION <br />1~3S Edgewater NW, Salem Oregon 97310 <br />TELEPHONE: ('~03) 373-1255 <br /> FAX # ($03) 373-1014 <br /> <br /> ..... FOR OFFICE"LISE ONLY <br />,,,R~venue Code 04-04-07-831.848,, <br />Plan Approval No.: <br />Date Received: <br />)ate Reviewed; <br /> <br />NOTIFICATION TO LOCAL ENFORCEMENT AGENCY <br /> <br /> The Prefabricated Structure Identified below requires completion work at the site as specified. <br /> Manufacturer Name: <br /> <br /> I Phone: <br /> <br />=Plant Location; <br /> <br />Installation Address t _ · -- .- Oc, cJ)panc~' Group <br /> <br />*/WHEN ~' WHEN <br />COIdPLETED ~ICO~PLETE ITEMS COMPLETED INCOMPLETE ~I;MS <br /> <br /> Minimum $60.00 payment due with application. ~ <br />Make check payable to the Building Codes Agency. Fees not subject to refund. <br /> <br />M-0058 10/18/91 <br /> <br /> <br />