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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: 888-7904 <br /> <br />of e registered builder, <br /> <br />Other. <br /> <br />I have read and agree to the terms stated on the reverse side of <br />this document, <br /> <br />IOWNER: i TAX LOT; ........... ~ ~ATE(2ORY: <br />i SANTIAM HOMES ~ RESIDENTIAL <br /> ~ CONSTRUCTION TYPE'. j OCCUPANCY: <br />I BITUB ADORESS; i I <br />¢ 116 CARMEl. DR -- j CONTRACT C TY; UGB [ OCCUPANT LOAD; <br />[ AUNSVILLE OR ?7325 ~, UMSVILLE iNO <br /> I NO OF BEDROOM$~ <br /> <br /> MANUFACTURED STRUCTURE <br />MAILING AOgRESS; <br /> <br /> 11~7~ MILL CREEK RD <br /> AU~SVILLE OR 97~25 <br /> PHONE: 7~9-7744 <br /> <br /> I 3 <br />SU BD~VI$ION~ <br /> <br /> L_L__CAEEE__F~T~TE~ ................ <br /> SITE NUHBER: 94-fi~774 <br /> VALUATION~ <br /> <br />............................................ ~ ........... i ZONE i MAP: <br /> BLOCK; i SECT ON: r TOWNBH P .......... ~--¢~R~i ............... <br /> <br />TYPE: NANUFACTUREB STRUCTURE PERNIT OR APPLICATION NO: <br />CONTRACTOR~ NO. 98940 <br /> Capitol Awning / Santia~ Ho~es <br />518 Val].eywood Dr SE <br />Salem~ ~7~06 <br />PHONE: 3&~-1711 <br /> <br /> ITEN <br />MANUFACTURED STRUCTURE PLACEMENT/CONNECTION <br /> <br />MANUFACTURED STRUCTURE STATE FEE <br />MANUFACTORE9 STRUCTURE STATE SIJRCHARGE <br /> <br />PAYEF: <br /> <br />TOTAL ASSESSE~ FEES <br />PREVIOUS RECEIPTS <br />THiS RECEIPT <br /> <br />~ALANCE'DUE <br /> <br />58473 <br /> <br />QUANTITY <br /> <br />INVOICE <br /> <br />AMOUNT <br /> $182.88 <br /> $20.00 <br /> $9.10 <br /> <br />$2:11.10 <br />$211.10 <br /> $0.00 <br /> <br />$0.00 <br /> <br /> RECEIVED BY: BI-- TYPE: CHECK ~: 0 <br /> $* THIS IS A VALID PERNIT ~ TN'rS PERHIT FEE CSVERS ONE INSPECTIOH AND ONE <br /> REINSPECTiON. ALL BLOCKING, STAIR INSTALLATION, P~flBING, HKCHANICAL. AN~ ELECTRICAL <br /> CONNECTIONS ARE REQUIRED ~ BE ~HPEETED ~OH REQUEST F~ THE FIRST INSPECTION. IF <br /> __..~HOF THE [TEHS ARE IHCOHPLETE. AH RDOIT~OHAL IH~CTIOH FEE ~ILL BE RE~U~RED. <br /> IT IS VALID FOR SIX ~ONT~ .~Y. ~E~ED FOR 6 HO~H5 UPOH ~RITTEH REQUEST FOE <br /> AN EXTENSiOH. PRIOR TO THE EXPIRATI~ DATE OF THE ~RHZT. IF CONSTRUCTIOH FAILS TO <br /> HEET ALL REGBIREHENTS OF STATE LA~S AMD H~RION COUNTY BUILDING AND ZOHIHG OEDIHRHCES~ <br />PLAHNIHG ACTION~ <br /> ~ SETBACKS: FR <br /> ~ ' ~ , , LS-15 <br /> RS-15 <br /> - AR-15 <br /> <br /> REMARKS: MS, CARPORT ,, , <br /> .... <br /> DONALD E. WOO~LEY~ MARIOH COUNTY BUIEDIH~ OFFICIAL / BY <br /> <br />OFFICE COPY <br /> <br /> <br />