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MARION COUNTY <br /> DEPT. OF BUILDING INSPECTION <br /> Senator Suilding # 225 <br /> 220 High St., N.E. 2nd Floor <br /> Salem, Oregon 97301 <br /> <br /> 588-5147 - 588.5148 <br />5:00 P.M.- ........... CODE-A-Phone 588.5373 ........... 8:00 A,M, <br /> <br />Type of Permit: wood <br /> <br />.Tax Lot No: <br /> <br />Address: 5267 Dumore Drive, SE <br /> <br />Sec. __.Twnshp. Rge ............ <br /> <br />Owner: Iven Findley Phone: 581-4344 <br />$1dr, & No.; Phone: ,,, <br /> <br />Plans by; Phone: <br />Map Page ] Zone Zone Chg, ' Part. Canal, Use <br /> <br />Address: <br /> <br /> Address; <br />Varlallce I Fire Zorle I Occupancy Type of Const. <br /> <br /> I <br /> Min Re~l, Fro~t Sides Resr <br /> <br />Lot No,: ,,, BIk. No.: .... Sub dv .... <br />Area of Bldg. 2nd Base- <br />Main Fir,: ........ Fir.: ...... ment: ,. <br /> <br />Roof Type: Truss/Stick:- <br />Heating Wood Water <br />System: Stove: Supply: <br />Septic Tank New <br />Site Evah ........... Instal · <br />Ex/st. No. <br />System: Gals · <br /> <br />Total <br /> <br />Lot Size Corner? <br /> <br />Valuation:__ <br />Bldg, Permit <br />Fee: ( + 5%) <br /> <br />Elect, Fee: ...... <br />Mech, Fee: i7.50 <br /> <br />VALIDATIONS. <br />Zoning: Mechanical= <br /> <br />Septic Tank: : Septic Tank <br />Dote; .Date; Permit <br /> <br />Plumb. Fee: ............ <br />State <br />Surcharge- * 7,,0.____ <br /> <br />I agree to build according to the submitted plans and specifications, the laws of the State DEQ Surcharge:__., <br />of Oregon and the Ordinances of Marion County. Permit expires if work not commenced <br />within ]80 days. I further expressly warrant that I comply with the provisions of ORS TOTAL FEE, ] R-~,~- ............ <br />701.005 fo 701.125 because: <br />( )l am performin~ ~o~k o, o property Iow, or occupy RECEIPT NO.: .... -~ ~ <br />( ) I om a regis~red builder OR ( ) the authorized ( ) The work will be performed by a registered builder <br /> representative of a registered builder ( ) Other ('p/ease specify) <br /> <br />REMARKS: <br /> <br />I have read this application i'r~ its entirety and certify that the stated informer/on is true and correct to the best of my knowl~Jge, <br /> <br />SIGNATURE OF ~PPL_iC~N~ ~ :,,, . .... <br /> PLEASE NOTE: Driveway and sidewalk inspections are re~ired by Public Work~ 588-5036 <br /> Other permits required by ~his deot: Plumbi~ ~ Electrical ~ <br /> <br /> <br />