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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 AOHSVI:LLE OR ~7~25 ~U~SVII..LE ~ ' <br />, ~ ~ ' <br /> <br />TYPE: MANUFACTURED STRUCTURE PERNIT OR APPLICATION NO: <br />CONTF;.ACTOR,~ NO,, 98940 <br />:Cal:)'i. tol A~nir!g / Sa~t:~ HoMes <br />518 Va],le~yeooc~'~r SE. <br /> <br />fCANUi-'AC'fURE;) SI'RUCTURE PI..ACEMIENT/CONNECTION <br />I.'lAi,~Ui?Al,'rOREO srRul;'roR~; STATE FEE <br />Mt'NUFACTtJ~ED STRUCTURE STATE SURCHARLiE <br /> <br />TOTAL ASSESSED FEES <br />F'REVIOU!~ RECEIPTS <br />THIS RECEIPT <br /> <br />57184 <br /> <br />QUANTITY AMOUNT <br /> <br />PAYEE: INVOICE 0 <br />RECE]:VED BY.~ 1[)~ TYPE: CHECK ~: 0 <br />~_.T._H~_S__Z~_~ VA~D PE.NZT ~* THZS,~[~ZT FEE COV[ES OWE Z.~"';~--~ ................................. <br />~ZN~F~U~IUN. ~LL BLOCKING~ .'STaiR ;'INSTALLRTION, 'PLUNBING, · ~ECHAfllCAL ANO ELECTRICA_ <br />CONNECTIONS ARE REQUIRED TO ~E CONPLE~D/UPON ~OUEST FOR THE FIRST I~SPECT~N. IF <br />ANY OF THE ITEMS ARE INCONPLETE;' AN ADOl'TIONAL.INSPECTION FEE WILL BE <br />P.E~flIT IS VALID FOR S~X NONTHS ~LY. 'RENEMEo.'FoR 6 HONTHS UPON aR~TTEN REQUEST <br />AN [XTENS[~H. PRIOR TO THE EXPIRATION DATE OF ~HE"PER~IT: ~F CONSTRUCTION FA~LS TO <br /> <br /> . SEI'BACK~: ER ''~' <br /> <br />R R" 15 <br />SF'-" <br /> <br />OFFICE COPY <br /> <br /> <br />