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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-PRONE: 588-7904 <br /> <br />I 8m performing WOrk on a property I own or occupy, <br />l am a registered builder OR ( )theauthorizedrepreBentBtive <br />ol a re~istered Puilder, <br />The work will be performed by a registered builder, <br />Other <br /> <br />OWNI~'f'E; 04/23/91 <br /> f~dVAL, AMY E. <br />SHUS ADDRESS <br /> <br /> 105 GUY MORE DR -- <br /> DEl'ROi T OR 97342 <br /> <br />USE OF BUILBING: <br /> <br />, TAX LOT: CATEGORY: <br /> 67006~000 <br />i QONSTRUCTI(~N TYPE; OCCUPANCY: <br /> <br />MAILING ADDRESS: <br /> <br />SUBDIVISION; <br /> <br />2529 COFFEY LN <br />~:~eC4'f'A ROE, A, CA 95409 <br />f~ONE: 707-586-3~80 <br /> <br />MAOI~EY . CREEff, <br /> <br /> SiTE NUMBER: 12746 <br /> VALUAT I ON: <br />:i BLOCK: 'SECTION: '. fc~w~§H'i'¢; ~A~eE: ZbNEi MAP; <br /> <br /> DEP~II: ~ AREA; I UNITS: IRREG, LOT; ~ CORNER: <br /> <br />RESIDENTIAL <br /> <br />TYPE: PLUIW~iNG <br /> <br />PE~'~Ii'F OR APPLICA'riON NO: 31617 <br /> <br />CONF~TOR, NO. <br />~JVAL, ~ Ei <br />2529 COFFEY LN <br />SANTA ROSA, CA 95403 <br />PHONE; 707-586-3280 <br /> <br /> ITEM <br /> LiN~,~, 1ST 100 FEET <br />¢40BILE HOME SEHER AND ~ATER CONNECTION <br />PLUr~BiNG STATE,~JRCHARGE <br /> <br />(~UANTiTY <br />1 <br />1 $25.00 <br /> <br />PAYEE: <br /> <br />TOTAE:AS'S~ED:FE¢'.~ $47.25 <br />PREVtfZCSRECEiP'rS $4?.25 <br />THiS RECEIPT SO.OD <br /> <br />BALANCE DUE $0.00 ,~ <br /> <br />INVOICE NO: 0 <br /> <br /> REOEIVEO BY: CL 'rYPE: CHECK g: 0 <br /> <br /> * THiS IS A VALID PE~41T * THi~: PE~IT EXPiRt~ 180DA~SFROlUl IT8 ISSUE OATE. IF <br />CON~TRUCTION~ I=OR A PERIOD OF180 OAY~,ORiFCON~TRUCTION FAII.~ TO I~=.~ ALL <br />~REI~UIRE~41~TS OF STATE LAN~ AND~iON COJNTY BUiLOINGANDZONIN~ ORDINANCES, THIS PERMIT <br /> ALL BI~:Ot4ENUt~ANDVOID. <br /> <br />RE]~RI~: MH CONN & WL <br /> <br />~ONALO E+ NOODLE¥, MARION COUNTY BUILDING OFFICIAL / BY <br /> <br />Foar~ ~ MG ~-s~ ~EV. ~o OFFICE COPY <br /> <br /> <br />