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Appl. Recd: <br /> <br />By: ~ <br /> <br />Type of Permit: <br /> <br /> MARION COUNTY <br /> DEPT, OF BUILDING INSPECTION <br /> Senator Building # 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 />Address: 572 N llth ST <br /> WLMMENTARY <br /> AUMSVILLE SCHOOL ~11 <br />Owner: <br /> <br />Phone: ( Address: <br />Phone: ~,l Address: <br /> Z246-5077 <br />Phone: Address: <br /> <br /> PLANS CHECK ONLY <br /> <br />By: ]%~1-r~ e <br />Date: 2/22/84 <br /> <br />Tax Lot No: <br />Sec. ,, Twnshp, __Rge <br /> <br />Bldr. & No ' <br /> <br />Plans by: GREGORY{:CKER <br /> <br />Use of BidE,: ~NO ee~rml. Min Reel, Front Sides Rear <br /> COO~DOR & ~'~ARD ENCL0~ ~' ~ S~b~ks: <br /> <br />a,PO BOX 19702 ?ORTLAD 97219 <br /> <br />Lot No.: ........... Blk. No.: Sub dv ........ Lot Size Corner? <br />Area of BIdg. 2nd Base- Total ¢ourt,~a=4-* t, 200 <br /> Main Fir.: Fir.: ment:~ Areo:~ Vaiuatiom <br /> Bldg. Permit <br />Roof Type: Truss/Stick: Fee: ( + 5%)_ <br />H~ting Woad Water <br />System:_ Stove: Supply= Elect. Fee <br />Septic Tank New <br />Site Eva[: Instal .... ~ch, Fee~ <br />Exist. No, <br />System:~ Gals., ~n ~ ~ Plumb. Fee:~~~. <br /> <br />VALIDATIONS: Surcharge:. <br />~oning: <br />Date: ~ Plons Chk. Fee: <br />Septic Tank: ~ 2--/~ --~¢ ,,pti, Tank <br /> ~ Date Permit <br /> <br /> I agree to build according to the submitted plans and specifications, the lows of the State DEQ Surcharge: <br /> of Oregon and the Ordinances of Marian County. Permit expires if work not commenced <br /> within 180 days. I further expressly warrant that I comply with the provisions of ORS TOTAL FEE:. <br /> ;e31'OO5 t° 701'125 because: ~_~ ~ <br /> ( ) I am performing work on a property I own or occupy RECEIPT NO.: .... <br />~,{ ) I om a registered builder OR ( ) the authorized ( ) The work will be performed by a registered builder <br /> representative of a registered builder ( ) Other (please specify) <br /> <br />REMARKS: <br /> <br /> have read th isapplice~ion if~ its ent/rery ~rt~the~ated informer/on is true and correct to the bes tofmyknow/edge. <br /> <br />SIGNATURE <br /> <br /> PLEASE NOTE: Ori~way and sidewalk inspections are ~quir~ by Public Works: 588-5036 <br /> Other permits required by this dept: Plumbing ~ Electrical ~ <br /> <br /> <br />