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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 />I am performing work on a property I own or occupy. <br />I am a registered builder OR ) the authorized representative <br /> ol a registered builder, , , <br />The work will be performed by e registered buitder. <br />Other_ ' <br /> <br />this document, <br /> <br /> oE'r~l T OR 973~2 <br /> <br /> 2529 ~FFE~ <br /> S~TA ~, CA 95403 <br /> ~E: ?0?-586-3280 <br /> <br />'W'IDTH: ~ ?EPTH: <br /> <br />TYPE: fvL~31LE HOf~E PER, lIT OR APPLiCATiON NO: 31615 <br /> <br />CONTRACTOR. NO. 38238 <br />SANT[AM I~:~ILE <br />11373 MILLCREEK RD SE <br />AUIvCSV[LLE OR 97325 <br />PHONE: 769-7744 <br /> <br />IvlOBiLE H(3~IE BA~E FEE <br />I~Di3ILE HO~E ~TATE FEE <br />FC3t3ILE HOME STATES LIRCHARGE <br /> <br />PAYEE: <br />RECEiVEO ~Y: CL <br /> <br />QUANTITY AMOUNT <br /> <br /> 15.~5 <br /> $5.25 <br /> <br /> $110.25 <br /> $110.25 <br /> $0.00 <br />':BALANCE-- (~IE $0.00 <br /> <br /> 1NVOICE <br />TYPE: CHECK <br /> <br /> <br />