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R-Fc-FNED <br /> MAR ®5 2021 <br /> Marion County MARION COUNTY <br /> OREGON BUILDING INSPECTION <br /> PUBLIC WORKS <br /> (503)588-5036 <br /> BOARD OF MARION COUNTY BUILDING INSPECTION <br /> covMamero WILDFIRE FEE WAIVER <br /> Kevin Cameron,Chair <br /> Danielle Bethell <br /> Colm Willis 1 _ A /� <br /> Address: 1// C ?TT_C C.. Ave_ �e6 , ORI, <br /> DIRECTOR <br /> Brian Nicholas,P.E. Conventional Frame: YX Manufactured Home:0/N <br /> 5(' O a,' <br /> y� Idd�'Y) <br /> ADMINISTRATION i►t <br /> Square footage of existing/previous conventional frame dwelling: 3 444 <br /> BUILDING )14)(1,0P-1-.1,0P+, <br /> INSPECTION Square footage of existing/previous covered patio and/or entry:jpares <br /> dnri R-1 XS <br /> EMERGENCY #of existing Bedrooms: 3 #of existing Bathrooms: 2- <br /> MANAGEMENT <br /> q <br /> ENGINEERING Square footage of existing/previous attached,garage: lv0 <br /> ENVIRONMENTAL <br /> SERVICES <br /> OPERATIONS Name: <br /> PARKS phone;Number: =55O-$f(p /-i1w . 53-loa3 rsa6S <br /> PLANNING <br /> Email Address: - cr4e5ev . %A5d1 ® m611). Cbm <br /> SURVEY <br /> BI(F:)Wildfire/Forms/DwellMrldfreFeewaiver <br /> 5155 Silverton Road NE•Salem,OR 97305-3802• www.co.marion.or.us/PW <br /> Printed on recycled paper• Reduce—Reuse—Recycle-Recover <br />