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AppL Revd: ~ rid-~ <br /> <br />By: p,~ <br /> <br />Date; ,u,rch 3~7B <br /> <br /> MARION COUNTY <br /> DEPT. OF BUILDING INSPECTION' <br /> Downtown Senator Suild[ng <br /> 220 High Sc,, N.E, 2nd Floor <br /> Salem, Oregon 97301 <br />R.~I. WITHROW, BLDG. ADMINISTRATOR <br />588-5147 - 588-5148 <br /> <br />Type of Permit; !7ood S~oVe <br /> <br />.Tax Lot No: <br /> <br />Address;_, 5577 '/)umo~-e Dr. Si~, :';umsvi]Le Or. Sec, <br /> <br /> ' ' ~ 364-5B12 s~,me <br />Owner: , ,~.c~ e.l. :i). !~k:~odwcrd Phone; , Address:_ <br /> <br />Bldr. & No,;. s"m'm Phone: Address: <br /> <br />Plans by: Phone: Address; <br /> <br />U~o of gldg.: M)n Req, Front <br /> Setbacks: <br /> <br />Permit No, <br /> <br />Twnshp. __Rge. <br /> <br />Lot No: BIk, No:, Sub dv. <br /> <br />Lot Size Corner? <br /> <br />Water SuppIv: wf~ l 1 Valuation; .... $ <br />Sewage Feas, <br />Disposal: Ii~N~t:ic . Study; Permit Fee: <br /> <br /> No, <br />Area of Bids; Stories; State Surcharge: _ <br /> Roof <br />Basement: Type: Plans Chk, Fee: <br />Heating <br />System: Septic Permit Fee: <br /> <br />7.00 <br /> <br />BTU: <br /> <br />Total Fees: 7. ?.g <br />Rcpt. No: (/ ~"~ <br /> <br />I agree to build according to the submitted plans end specifications, the laws of the State of Oregon and the Ordinances of Marion <br />County. Permit expires if work not c~r~me~ced within 120 days. / ~y <br /> <br />VALIDATIONS: <br />ZONING SEPTIC TANK PLANS ~ ~ <br />D.ta: Date: D.te: ~. 5-' <br />REMARKS <br /> <br />PLEASE NOT~:: Driveway and sidewalk inspections are required by Public Works: 688-5036 <br />Other permits required by this dept: Plumbing [] Electrical L~ <br /> <br /> <br />