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.~ - MARION COUNTY
<br />/~ ~. W /~.,,/.~,/,,.,././~J DEPT. OF BUILDING INSPECTION
<br />~ ~F~2~ ~.ator ~,ilding ¢225
<br />Appl,~ecd,: ~:_,~,/ /~¢ 220 High St,, N.E. 2nd Floor
<br />~ ~ . /I Salem, Oregon 97301
<br />
<br /> ,,~ /~ 588-5147 -- 588-5148
<br /> Date. : /6h8' 86,, d-/~-~ P,M ....................... CODE-A-~hone ...................... 8:00 A,M.
<br />
<br /> Type of Permit: ::,,bD~',FIO~ ~Q SCH,?,OL * SZOF Tax Lot No.:
<br />
<br /> 561
<br />Permit No.:.
<br />
<br /> Dottle
<br />By:
<br />
<br />Date: 6/24/86
<br />
<br />Address: 572 N 1] T];~ U~,ISVILL£
<br />
<br />Sec.:~Twnshp,: 8 Rge.: ..... 2W
<br />
<br />Owner: .,~,riM.'-;9'/'CI.E E}',R~¢, . ,~r~.;OI, Phone;~ddress;
<br />
<br />Bldr. & No.- T~':~.~;:~.R HOM% RE!:'t,D~gL'r.Z~I;~one: 23 ddress: 23757
<br />
<br />Plansby: ,A,¢A¥:;', CJ~lP, gl, ~ A, C,:'~I~Lg(!NPhone:~ddress; 3085 ;'(IVER RD ~ ~(-' /:;':
<br /> Map Page ..... Z'one Zone Change Part. I Cond, Use Variance/Adj. FT/Ffl O~oupancy Type of Const.
<br />
<br />Lot No.: BIk, No,' Sub. dv.:
<br />Area of Bldg, 2nd Base~
<br />Main Fir.: ~.6_Z_2, Fir.: ~ent:
<br />
<br />Roof Type: r~i~)"LT ~;? Truss/Stick' STICK
<br />Heetlng Wood Water
<br />System: ¢,¥4 e~Stove; uo Supply:
<br />Set, tic Tank New
<br />Site Eval.; C~ ~y In~tel.:
<br />Exist. No,
<br />System: Gals,:
<br />
<br />VALIDATIONS:
<br />Zoning:
<br />Date:
<br />Septic Tank:
<br />Date:
<br />
<br /> Lot Size; 162 x 280 Corner?__
<br />Total
<br />Area; 672 s~. ft. Valuation:
<br /> Bldg. Permit
<br />Height: 12 ft· Fee: ('- 5%)
<br />
<br />city Elect. Fee:
<br />
<br />Mech, Fee:
<br />
<br /> Mechanical:
<br /> Date:
<br />
<br />I agree to build according to the submitted plans and specifications, the laws of the
<br />State of Oregon and the Ordinances of Marion County. PERMIT EXPIRES IF WORK
<br />NO T COMMENCED WI THIN 180 DA YS. I further expressly warrant that I comply with
<br />
<br />the provisions of ORS 701.005 to 701,125 because:
<br />
<br />( ) I am performing work on a property I own
<br /> or occupy
<br />( ) I am a registered builder OR ( ) the
<br /> authorized representative of a
<br /> registered builder
<br />
<br />I~ ) The work will be'performed
<br /> by a registered builder
<br /> Other (please specify)
<br />
<br />Plumb. Fee:
<br />State
<br />Surcharge:~(4..~.)_ 4~. ] ~]
<br />P,aes Chk. ee: ._._Z=Z
<br />Septic Tank
<br />
<br />DEQ Surcharge:
<br />
<br />· .......
<br />
<br />RECEIPT NO,:
<br />Driveway
<br />Permit Fee:
<br />Site Plan
<br />Review Fee:
<br />Public Works
<br />Receipt No,:
<br />
<br />REMARKS:
<br />
<br />SIGNATURE OF
<br /> PLEASE NO/; [~,iveway a~nd/dewa,~
<br /> Other permits require by this dept.: Plumbing
<br />
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