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AppL Recd,: By: Dottie Date; 3/11/85 MARION COUNTY DEPT. OF BUILDING INSPECTION Senator Building #225 220 High St,. N.E. 2nd Floor Permit No.: ~5=.270 Salem. Oregon 97301 588-S141 -- §88-5148 By: ~,,a TTY 5:00 P.M ....................... CODE-A-Phone ...................... 8:00 A,M. Date: 3-23-85 Type of Permit:- A__ 10772 Leverman Road, SE ~ .xJ, ~_ Owner: XJO~X2~ ?ivian Wilson Phone.~? G.K. King,bury Phone: ~8-81~ 81dr, a No,' ....... ~25230 Plans by; .Phone: ~ Zone Change remodel Fire damage ,~epair & addiug new din~.iug rOO~Tex Lot No.:_ se .: T, nshp.: Address; Address: Address; 630 Marion Street, NE salem 9730i #149 Lot No,: .,, SIk. No.',, Sub, dy.: ,, Area of Bldg. 2nd Base- Total Main F~r,: ~40 _Fir.; merit: Are~:_ 240 Roof Type: comp Truss/Stick: etick Heating Wood Water System; Stove: Supply: Septic Tank New Site EvaL: ,Instal.: Exist. NO. System: __Gals.: Height:_2 story VALIDATIONS: Zoning:~ / ---- Septic Tsnk; ' Cate: Mechanical; ~Date: .,, Date; ~'~- I agree to build according to the submitted plans and specifications, the laws of the State o1 Oregon and the Ordlnances of Marion County. PERMIT EXPIRES IP WORK NO T COMMENCED WITHIN 180 DA YS. I further expressly warrant that I comply with the provisions of ORS 701.005 to 701.125 because: ( ) I am performing wor~ On a property I own or occupy ( ) I am a registered builder OR ( ) the authorized representative of a registered builder ( ) The work will be performed by a registered builder ( ) Other (p/ease specify) Lot Size', _Corner?~ Valuation: 28,000,~ Bldg. Permit 184.00 Fee; (+ 5%) __ q Elect. Fee: 20.00 TE Mech. Fee:__ Plumb. Fee: State ~ Surcharge: (4%) 8.16 Plans Chk. Fee: Septic Tank Permit Fee: ,, 119.60 OEQ Surcharge: TOTAL FEE: BLDG. RECEIPT NO,: Driveway Permit Fee; Site Plan Review Fee: Public Works Receipt No.: 340.96 R~MARKS:. I have read this application in its entirety end certify that the stated information ia true and correct to the beat of my know/edge.