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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG. NO. 225 <br />220 HIGH STREET NE <br /> SALEM1 OREGON 97301 <br /> <br /> PHONE: 588-8147 8:00 - 4:30 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />OWNEm: ~)ATE: 0~/20/B.4 .... TIME.'.-I.l:.O~:.05 ....' .... <br /> DEYt_IN~ SEAN RESIDENTIAL <br /> <br /> 403 DURBIN QR -- 31 : CONTRACT CfTY; i UGB; {OCCUPANT LOAD: <br /> AUHSV~LLE OR ~7325 ~ AUMSV~LLE NO ; <br /> <br /> HANUF'ACTURE9 STRUCTURE 3 <br /> <br /> 283? KEHNE~Y CTR NE <br /> KEIZER, O~ ~73~ ~ SITE NUMBE~: ~4-823~5 <br /> PNONE: 37~-~58~ V~LUATION~ <br /> <br />;'LOT: :BLOCK: :SECTION: ,TOWNSHIP: i RANGE: [ ZONE; ! MAP: <br />~ 55 I 102i 5610.' NO NO <br /> <br />TYPE: flANUFACTURED STRUCTURE PERMIT OR APPLICATION <br />C?[TRACTOR, NO, ?8?40 <br /> Capit9~ <br />518 Va~eywood"Dr SE <br />Salem~ 97~06 <br />PHONE: ~63-t711 <br /> <br />557~I <br /> <br /> ITEM <br />MANUFACTURED STRUCTURE PLACEMENT/CONNECTiON <br />MANUFACTURED STRUCTURE STATE FEE~ <br />MANUFACTURED STRUCTURE STATE SURCHARGE <br /> <br />QUANTITY <br /> <br />AMOUNT <br /> $182,00 <br /> <br /> $%10 <br /> <br />TOTAL ASSESSED FEES <br />PREVIOUS RECEIPTS <br />THIS RECEIPT <br /> <br />$,11,10 <br />$211.10 <br /> $0.00 <br /> <br />BALANCE DUE $0.00 <br /> <br /> PAYEE: INVOICE <br /> RECEIVED BY: PB TYPE: CHECK ~: 0 <br /> <br /> ~* THIS IS A VALID PERMIT /At ~rllS PERMIT FEE COVERS ONE INSPECTION AND ONE <br /> REINSPECTIOM. ALL BLOCKING, STAIR INSTALLATION. PLUMBINg, MECNANICAL. AND ELECTRICAL <br /> CONNECTIONS ARE REQUIRED TO BE COflPLETE~ UPON REgUEST FOR'THE FIRST INSPECTION. IF <br /> ANY OF THE ITEMS ARE IMCOHPLETE. iAN ~DIT[SNAL INSPECTION,FEE MILL SE REGUIRED. <br /> PERMIT IS VALI~ FOR SIX ~ONTHS ONLY. RENE~ED'FUR ~ MONTHS UPON ~RITTEN REGUEST FOR <br /> AN EXTENSION, PR[OR T~ THE EXPIRATION DATE OF THE PERMIT. IF CONSTRUCTION FAILS TO <br /> HEET ~LL REQUIREMENTS OF STATE LA~S AMD MARION COUMTY,BUILDIN~ AND ZONING ORD[HANCES~ <br />PLaNNiNG ~CT~ON: <br /> SETBACKS: FR 10 <br /> LS-15 <br /> RS-15 <br /> RR-10 <br /> ~;H~.MARKS: MS, CARPORT <br /> DONAL~"'E, W(IODLEY~ MAR310N COoNTY ~UILD~WG OP~ICIAL / BY ........... _~_.. .......................................... <br /> <br /> OFFICE COPY <br />FORM # MC '15-~6 REV, 4/90 <br /> <br /> <br />