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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLOC, NO, 225 <br />220 HI~ STREET NE <br /> SALEM, OREGON 97301 <br /> <br /> PHONE: 588-514,7 8:00 - 4430 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br /> ~ RESIDEHTIAL <br /> '¢iYd~' XDD~E~". ~ CONSTRUCTION TYPE'. j OCCUPANCY: <br /> ' <br /> 222 BELLEVUE -- 72 : ....... ~'~v (0~ 1808bPANT LOAD: <br /> AUH,,W~Li_E OR <br /> <br /> r HILL CREEK ESTATES <br /> 17277 S FERHWO0~ RD <br /> ~OLALLA, OR 97~38 I SITE ~U~ER~ <br /> PHONE:: 82~-2~8 <br /> . ~ VALUATION: <br /> <br />~ .DCY: ................... F~E~A ................ F~C~T~ .......... FfSW~A~' ~ RA~E ; ZONE; : MAp: <br />~ 72 ~ i 24 8~ ~ 2W <br /> <br />k i i <br /> <br />TYPE: MANUFACTURED STRUCTURE PERHIT OR APPLICATION NO: <br />CONTRACTOR. NO. 14922 <br /> COHH Woodburn In(; <br />28,5 S Pacific HWy <br />Woodb .~r n.~ 97071-0000 <br />PHONE. 781-3141 <br /> I rEM ': <br />HANUFACTURE~ STRUCTURE PLACEMENT/~ONNECTZON <br />HANUFACTURE~ STRUCTURE SLATE F'EE <br />MANUFACTUREO STRUCTURE ~TATE SURCHARGE <br /> TOTAL-ASSESSED EKES <br /> PREVIOUS RECEIPTS <br /> THIS RECEIPT. <br /> <br />PAYEE: JOHN ROEHH CONSTRUCTION <br /> TYPE:: <br /> <br />9~6817~ <br /> <br />QUANTITY ANOIJNT <br /> $182,,00 <br /> $20.00 <br /> $9.10 <br /> <br />$211. lB <br /> $0.00 <br />$~I 1.10 <br /> <br />INVOZCE 62777 <br />CHECK ~: 0 <br /> <br />RECEIVED BY: Pi4 ..,: <br /> <br />)~ THIS IS HOT A PERMIT. THIS APPLICATION MUST GO THROUGH REVIEW PROCESS WHERE THE <br />FOLLOt~'J[I,[I; NUST BE COI~PLETED. IT IS THE RESPONSIBILITY OF THE APPLICANT TO ASSURE <br />THAT ALL NECESSARY IHFORMATION HAS BEEN PROV:I~'ED, <br /> <br /> ..................................................... <br />CITY JURI,)I)ICT I OH,. <br /> <br />OFPICE COPY <br /> <br /> <br />