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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 />of a registered builder, <br /> <br />Other. <br /> <br />SIGNATURE OF APPLICANT; <br /> <br />i MIEBACN, CORIE & CNAD !58271-000 ~R~ESIDENTIAL <br /> <br /> 717& BATES ROAD SE ,. CONTRACT C~TY: r UGB: OCCUPANT LOAD; <br />~ AUMSVII..LE OR ?7325 ~ARION COUNTY ~NO <br /> <br /> DAY PHONE : CHAD 747-1822 .i <br /> SITE NUMBER: 94-8~4s7 <br /> PNOHE: 74<2-1026 VALUATION: <br />L~T: iIBLOCK: j SECTION: TOWNSHfP; ~ RANGE'. ~ ZONE: :MAP: <br />;WIDTH:; ~DEPTN: ~ AREA:34 ¢ UNITS'.~ 8$ :' ~WiR~E~. LOT: ; O~ER: ~5~ <br /> <br />TYPE: MANUFACTURED STRUCTURE PERNZT OR APPLICATION <br />CONTRACTOR. NO. <br />HIEBACH~ CORSE & CNAD <br />~AY PNONE : CHAD 747-1822 <br /> <br />PHONE: 749-'1826 <br /> <br />iTEM <br />MANOFACTURED STRUCTURE PLACEMENT/CONNECTION <br />MANUFACTURED STRUCTURE STATE FEE <br />MANUFACTURED STRUCTURE STATE SURCNAR~E <br />MANUFACTURE~) STRUCTURE ZONING SURCHARGE <br /> <br />TOTAL ASSESSED FEES <br />PREVIOUS RECEIPTS <br />THIS RECEIPT <br /> <br />57884 <br /> <br />QUANTITY AMOUNT <br /> $182.00 <br /> $20.00 <br /> $9.10 <br /> $15.00 <br /> <br />$226.10 <br />$226.10 <br /> ~0.00 <br /> <br /> BALANCE DUE $0.00 <br />PAYEE: RECEIPT <br /> <br /> RECEIVED BY: dM TYPE: CHECK ~: 0 <br /> ~ THI~ TS A VALID PERNIT ~ THIS PERMIT FEE COVERS ONE 'INSPECTION AND ONE <br /> REINSPECTION. ALL BLOCKZNG, 'STAIR INSTALLAT~ON~ PLUMB[NC, HECHANIC~L. AN~ ELECTRICAL <br /> CONNECTIONS ARE REQUIRED TO BE COHPLETED ~OH ~OU~T FOR THE F~RST ~NSPECTiON. <br /> ANY OF THE [TEHS ARE ~NCOHPLETE~ AH ADDiTiONAL [HS~CT~ON FEE ~ILL BE REGU[RED. <br /> PERH/T [S VALZD FOR SIX HOHTH~' OHLY. REHEME~ ~R &'HOHTHS UPON ~R[TTEN REDDEST FOR <br /> AN EXTENSXOH. PR[UR T~ THE EXP[RATIDH 9ATE OF' ~E PERH~T. IF CONSTRUCT[OH FA[L~ TO <br /> HEET ALL REDUZREHENTS OF STATE LA~S ~HD H~[OH COU~Y ~U/LD[Hg <br />PLANNING ACTION: : , <br /> SETBACKS: <br /> LS .... <br /> RS ............ <br /> ER ....... <br /> SP <br /> REMARKS:; MS:REPL. REL. kEVI,~ED SITE PLAN 18/~/~4.. ~EXISTING IDENCE MUST-BE REMOVED. <br /> ONE ~WELI_ING ALLOWEO ON PROPERTY ~ <br /> DONALD E. WOOOL, EY~ NARION COUNTY BUILDIN60TFICIAL / BY ........... ~ <br /> <br /> OFFICE COPY <br />FORM # MC 15,St) REV, <br /> <br /> <br />