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AppI. Recd.: C~ris Date: 12-2-8,5 MARION COUNTY DEPT. OF BUILDING INSPECTION Senator Building #225 220 High St., N,E, 2nd Floor Permit No.: Salem, Oregon 97301 588-5147 -- 588-5148 By: 5:00 P.M ....................... CODE-A-Phone ...................... B:O0 A.M. Date: 85-1165 12-17-85 Type of Permit: Chuuch Addi't_i.oo Office,Recep.&Waitinq Rm~ax Lot NO.: Address: Owner: 9168 Silver Falls Highway SE Aums. 13 x~ 8 S Sec.: __Twnshp,: Rge.: (Sh ) Father Charles Taaffd St. Mary's Parish ag Phone:~ddress: 97395 same G$ a~ove Bldr. & N6~Jam Ziebar~ 2W Phone: 363-2202 Address: 7750 Aumsville Hwy ~ 97301 Plans by: _Phone: Address: Zone ChartS' ....... Con d. tJ ,e~:~ V ar la hca/ad,, FT/FD j O~upancy ] TypeofC nat, Map Page Zorte Part. NO. adrma. Min Req. Front ' ] Sides Rear Uae of SlOg,: Public or Ccc. Ld.: Setbacks: ~'t(~ [ /~ --~ Lot No.: elk, No,: Sub. dy.: Lot Size:. acc,us Corner? Area of Bldg, 2nd Base- Total Main Fir,: 1003 Fir,; merit: Area: 1003 Contr- Valuation: Bldg. Permit Roof Type: --~//~ Truss/Stick: ~"~C~/"~ Height: -~,.~ ¢ Fee: (+ 50/0) 9.20 Heating/ -- · ..-Weed Water System: ~/E ~ ~ve: Supply: Well * Elect, Fee: Septic Tank New Site Eval.: Instal.; Exist, No. System: ,,, Gals,: VALIDATIONS: Zoning; _~-.¢~ 'J~ Mechanical: Date: /2~w ~---~ h--/~ Date: Septic Tank: Plans: -- _ .... //~/,--~.-. Date: Existing ____Date; .;~A /~'-~ ~.w I agree to build according to the submitted plans and specifications, the laws of the State of OregOn end the Ordinances of Marion County. PERMIT EXPIRES IF WORK NOT 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 work on a property I own or occupy ( ) I am s registered builder OR ( ) the authorized representative of a registered builder The work will be performed by a registered builder Other (please specify) Mech. Fee: Plumb. Fee: State Surcharge; (4%) 7,36 REMARKS:''~" ~__ ~,.-- ~..-. --- ~. I have read this application in/ts entirety and ce~y that the stated information is ~ and correct to the best of my knowledge, SIGNATURE OF APPLICANT; _ / PLEASE NOTE: Driveway and sidewalk insp '~are required by Public Works: 588-5036 Other permits required by this dept,: Plumbing [] Electrical [] Mechanical [] DEQ Surcharge: __ TOTAL FEE: 320.16 RECEIPT NO,; Driveway Permit Fee: __ Site Plan Review Fee- Public Works Receipt No.: __ Plans Chk. Fee: 119.60 Septic Tank Permit Fee: