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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG, NO, 225 <br />220 nIGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br />PHONE: $88-5147 8:00 - 4:30 <br />HOUR CODE-A-PHONE: 588-7904 <br /> <br />of a registered builder, <br />The work will be per¢ormed bY a registered builder. <br />Other <br /> <br />ISiTOB /~:¢GI]~-S~AM 'I4OHE'S ............. i:'8~)NSTROOY~ON TYPE'. <br /> J , <br /> <br />USE OF BUILDING: ; ~NO 0F BE0~00M5: <br /> <br /> ~ '-M~EL' CRE~-EST~TES <br /> 11~73 MILL CREEK R~ <br /> AUMSVILLE OR ~7325 <br /> PHONE: 76~-~744 ~ALUATION: <br /> <br />TYPE; HAHUFACTURE9 STRUCTURE PERfllT OR APPLICATIOH tlO: <br />CONTRACTOR~ NO. ~8940 <br /> Capitol Awning / SantiaM Hone$ <br />518 Valleywood Dr SE <br />Salem, ~730& <br />PHONE: 36~-1711 <br /> <br /> ITE~ <br />HANUFACTURED STRUCTURE PLACEMENT/CONNECTION <br />MANUFACTURED STRUCTURE STATE FEE <br />MANUFACTURE9 ~TRUCTURE STATE SURCHARGE <br /> <br />TOTAL ABSESSEDFEES <br />PREVIOU~ RECEIPTS <br />THIS REOEIPT <br /> <br />9~848~ <br /> <br />QUANTITY AMOUNT <br /> $182.08 <br /> $20.0B <br /> $9.:1,0 <br /> <br />$211.18 <br /> $0.08 <br />$211.10 <br /> <br />B~LANCEDUE $0.08 <br /> <br />PAYEE: 6a~i,~o!.Awnlng / Santiar~ Homes INVOICE 61031 <br />RECEIVED BY. ~1- TYPE: IFf CHECK 8: 0 <br />~ THIS IS HOT A PERHIT. THIS APPEI~TION HUST ~ ~ROU~ A ~VIEW PROCE~ WHERE THE <br />F~LO~HGHU~T ~ COH~ETED.: IT IS THE RESPO~ZL~TY ~ THE APPLICA~ TO AgSURE <br />THAT AIl ~CESSARY ~HFO~AT~OH ~S ~EH PROVIZ. <br /> <br />PL. AI,IN ~ NG ACTION: <br /> <br /> CITY JURISDICTION.# BY ........ DATE .......... <br /> REMARKS: tiS, CARPORT <br /> <br />~EI'BACK8: <br /> <br />FR 10 <br /> <br />RR"15 <br />sPE/ <br /> <br /> OFFICECOPY <br />PORM # MC 15,66 REV. <br /> <br /> <br />