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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 am berfornling work on a property I own or OCCUpy. <br /> <br />of a registered builder, <br /> <br />I have read and agree to the terrn8 stated on the reverse side of <br /> <br />s~Tus ^oeR~ss; ................ t: RE,SI~ENT~AL <br /> <br /> I,i~7~ H~LL gREEK RD <br /> PHONE: $~-8147 V~LUATION= <br /> <br />TYPE= MANUFACTURE~ STRUCTURE <br /> <br /> ~api~ol ~wni~g_/ Sa~tiam Ho~e~ <br />518 Valle~wooo' ~r' SE <br />SaleM~ 97~06 <br />PNON[: ~4~-1711 <br /> <br /> ITEM <br />MANUFACTURED STRUCTURE PLACEMENT/OUNRECTION <br />NAHUFACTURED 8TRuc'ruRE STATE FEE <br /> <br />PERMIT OR APPLICATI~INO= 5~81~ <br /> <br />QUANTITY <br /> <br />AMOUNT <br /> $182.00 <br /> $20.00 <br /> <br /> NAI4UFACTIJRED STRUCTURE STATE SURCHARGE, <br /> TOTAL::' ASSESSE]) FEES $211.10 <br /> PREVIOUS RECEIPT~ $~11.10 <br /> THIS RECEIPT $0.00 <br /> <br /> PAYEE: ~ INVOICE <br /> RECEIVED BY: DF ~]~_. ] CHECK ~: <br /> $~ THIS IS A VALID PERMIT: ~: THIS PERMIT:FEE COVERS ONE.INSPECTION AND ONE <br /> REZHSPECT[OH. ALL ~LOCK~NG~: STAIR, ~NSTALLRT[ON~ PLUH~HG~ HECHAN[CRL. <br /> COflNECT~0HS RRE REgU~RED TO ~E.:COHPLE~ED UPOH;:REg~EST FOR THE F~RST ~RSPECT~ON. <br /> ANY OF THE ITEMS ARE INCOMPLETE. RDD[TION~E iflSpECT[~ FEE WILL BE REaUIRE~ <br /> PERMIT IS VALI9 F~R SIX HONTRS:ONLY:, EENE~B FOR & HONTHS BPON ~EITTEN REQUEST FOR <br /> ~N EXTENSION. PRIOR T0 THE :EXPIRATION D~TE GF:~ ~E~T;' IF CQNSTRUCT[~ FAILS <br /> flEET ALL REQUIREMENTS OF AND ZONIN~ OR~INANCES~ <br /> <br /> SETbaCKS: FR <br /> <br /> RS""t5 <br /> RE-15 <br />RENARKg; MS SP] <br />~OHAL,,D E. WOODLEY~ HARION COUNTY BUILDIN~ OFFICIAL / 'By <br /> <br />OFFICE COPY <br /> <br /> <br />