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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 />0912819,4 ~.I ~[_.....i~.-6.5~ <br /> <br />75~;81386 <br /> <br />, OWNER: <br /> KtLMARTIH~ PAT <br /> <br /> 5750 FILBERT CREEK LANE SE <br /> AUMSVILLE OR 9732§ <br /> <br /> CONTRACT CITY; JOB'. <br />MARION COUNTY NO <br /> <br />RESIDENTIAL <br /> <br />MANUFACTURE~) STRUCTURE <br /> <br />234 NO. CENTER <br />SUBLIMITY ~7385 <br />PHONE= <br /> <br />SITE NUMBER: 94-82~85 <br />VALUATION: <br /> <br />14 8S <br /> 2.~8~ AC NO <br /> <br />TYPEm MANUFACTURE9 STRUCTURE <br />CONTRACTOR~ NO, ' <br />KILHARTIN. PAT <br /> <br />SUBLIMITY 97385 <br />PHONE~ 769-7596 <br /> <br />PERNIT OR APPLICATION NO: 5R~39 <br /> <br />ITEM <br />MANUFACTURER STRUCTURE PLACEMENT/CONNECTION <br />MANUFACTURED STRUCTURE STATE FEE <br />MANUFACTURED STRUCTURE STATE SURCHARGE <br />MANUFACTURED STRUCTURE ZONING SURCHARGE <br />flANUFACTUREB STRUCTURE CURB ~/W BUIL~INC INSPECTION <br />MANUFACTURED STRUCTURE CURB D/W PUBLIC, WORKS <br /> <br />TOTAL ASSESSED FEES <br />PREVlOUSRECEIPTS <br />TNISRECE[PT <br />,BALANCE DUE <br /> <br />QUANTITY <br /> <br />PAYEE: RECEIPT <br /> <br />AMOUNT <br /> $182.80 <br /> $20.00 <br /> $9.10 <br /> <br /> $~.5~ <br /> $7.80 <br /> <br />$2~.&0 <br />$233.60 <br /> $0.00 <br /> <br /> RECEIVED BY: DM ................................. TYPE: CHECK f: 0 <br /> <br /> $~ THIS Is A VALID PERHIT $~ THISPERHiT FEE. COVERS ONE ·INSPECTION AND ONE <br /> REINSPECTION. ALL RLGCKING~ STAIR',INSYRIJ~.~TION~ PLONaiNG, HECHANICAL~ AND ELECTRICAL <br /> CONNECTIONS ARE RE~U[REO TO ~ECO~PLETE'I) UPON RE~UESTFOR !THE FIRST 'INSPECTION. IF <br /> ANY OF THE ITEHS ARE INCOMPLETE~IH: ADDITIONAL IHSPECTION FEE MILL BE REGUIREO. <br /> PERHIT IS VALID FOR SIX NONTHS OHLY....RENEBEB FOR 6 NoHTHSuPON ~RiTTEN REGUEST FOR <br /> RN EXTENSION~ PRIOR TO THE EXPIRaTION,DATE:OF THE PERHIT. IF CONSTRUCT[OH FAILS TO <br /> HEET ALL REOU~RENENTS OF STATE LR~S AND HARION COUNTY BUILDING AHD ZONING ORDiHANCE9, <br />PLANNIIqG ACTION. <br /> <br /> · BET~ACKS= FR 20 <br /> LB-lO <br /> R$-10 <br /> RR-~O <br /> SP <br /> REMARKS: MFS HOHE/$TD SYS W PUMP ~-1~-94. SEE SITE PLAN DATED 9/2~(94. BETHEE-EXCAVATIOI% <br /> INSTALLER. PRE-CONSTRUCTiON ,STAKEOUT RECOMMENBED. k\/' <br /> DONALD E. ~OODLEY, MARION COUNTY BUILDING OFFICIAL / BY ........... J~_ ..................... <br /> <br />OFFICE COPY <br /> <br /> <br />