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MARION COUNTY BUILDING INSPECTION <br />SENATOR SLDG, 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 />Other ............ <br /> <br />this document <br /> <br />SIGNATURE OF APPLICANT: <br /> <br />3"he C~ty h~ }vrlsdlction for review <br />F}~ app[ov~l e~ plame, ~d inspec- <br />hon of the ~y~te~, Contact the city <br />prior to begH~ntn9 construction. <br /> <br /> ~ j ~bO~PANT LOAD: <br /> CONTRACT CITY: j UGB: <br /> ,120 ;ARHEL. DR , <br /> <br />BOX 278 <br />HLJB~:~AR]). OR 97~J2 ~ SITE NUMBER." 95-~267 <br />PI-lONEr; 98:L--4125 ~ VALUATION',: <br /> <br />TYPE: MANUFACTURED STRUCTURE <br />liON 11'(AIFI'(]R. NO. <br />CAMPT~ELL ]"IOMES <br />7~:1.:1, SQUIRRIFL HII,.t., RP <br /> <br />PHONE'.: 375-8234 <br /> <br />PERMIT OR APPLICATION NO: &~764 <br /> <br />NAI,JUI::'ACTURED STRUCTURE; ~ ~¢, ;EHEN't'/OONI,~E'r_;T];ON <br />IfiAHU--A,;TURED .SI'RUCFU,~[ STATE; ¢'£E~ ; <br />I,IANUFACTURED STRUCT[JRE STATE SUR(..HARGE, <br /> <br />EE,~ <br /> <br />PAYEE= '~ <br />RECEIVF. D BY: DF' ::; <br /> <br /> 8. THiS IS A VALI~ PERMIT; <br /> REIMSPECTZON. ALL BLOCK] <br /> CONNECTIONS ARE <br /> ANY OF THE ITEMS ARE <br /> PERMIT IS VALID FOR SIX <br /> AN EXTENSION. PRIOR TO <br /> MEET ALL REQOIREMENTS <br />F'L. AHN;~NG ACTION:: <br /> <br /> HARk.,, <br />POI'4C'L [> E,., <br /> <br />MFq HOHE .- SP,~,99 <br />W{'ODJ EY, HARtON C00NTY BU:i!LDING OFFICIAl, / BY <br /> <br />Q U A Fi T I T Y A M 0 if N'T' <br /> $182,, 00 <br /> $20.00 <br /> $9., 10 <br /> <br /> $2.t 1 ,, 10 <br /> $211.10 <br /> SM ,, <br /> <br /> $0.00 <br /> <br /> " INVOICE <br /> ': CHE6K :ii:." <br /> <br /> AND ONE <br /> MECHANICAL. AND ELECTRICAL <br /> FIRST INSPECTION. IF <br /> ~LL BE ~ESU[~E~. <br /> UPON WRITTEN REQUEST FOR <br />IF CONSTRUCTION FAILS TO <br />:?:C:OU~Y::BUI~DZHG AND ZONIWG ORDINANCES, <br /> SE'TBACKS; FR 1~ <br /> Ro 1,~ <br /> SF",~ ........ <br /> <br /> OFFICE COPY <br />FORM # MC l §.§6 REV, 4/90 <br /> <br /> <br />