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Appl. Revd: ; )i'h' AY <br /> <br />By: {] :::dr~L <br /> <br /> MARION COUNTY <br /> DEPT. OF BUILDING INSPECTION <br /> Senator 13u[Idlng # 225 <br /> 220 High St., N.E. :]nd 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 />Permit No. '~/'~/'C> .~/ <br /> ~ <br /> <br />Type of Permit: <br /> <br />Address:,_~-')¢.'JC <br /> <br />Bldr. & No.; <br /> <br />.Tax Lot No; <br /> <br /> .Twnshp, Rge <br /> <br />Plans by; <br />Map Page 1 Zone Zone Chg. Part. Cond. Use <br /> <br />Lot No; .BIk. No: <br /> <br /> ~_ Sec. <br /> Phone: !)~2-'~~° Address; <br /> <br /> Phone: AddressD ~ ' ~ T~peof Con~ <br /> Varian~ Fir~Z~ne Occ~pancv ~ ' <br /> <br />Sub dy, Lot Size Corner? <br /> <br />Water Supply; Valuation: $, 2:' ~0.00 <br /> <br />Sewage.,~ ~ ~.~-, ._ Site ,,,~.0. ~--~ <br />Disposal: ~ ~) Evah Permit Fee: <br /> <br /> No. <br />Area of Bldg: ;-!L!. ~c (~L~ Stories: ~- , State Surcharge: _3_ ~ 2t <br /> <br /> Roof <br />Basement: Type: Plans Chk. Fee: ~- z o ~,~ <br />Heating <br />System: Septic Permit Fee: <br /> <br />BTU; Total Fees: _5t. 12 <br /> Rcpt. No: ~ a ~ <br /> <br />VALIDATI?I~S: <br />ZONING ',~ SEPTIC TANK PLANS <br /> <br />I agree to build ~cordlng to the submitted plans and sp~ificat/on$, the la~ of ~e State of Oregon and ~e Oridnances <br />County. Permit expire5 if ~rk not commenced within 120 days. I furhter expressly warrant thet I comply w/th ~he provisions of OR5 <br />70~.~5 to 70L 125 because: <br /> <br />( ) lamar~i~ter~bu//deror( ) ~eauthorfz~repre~ntatlveofar~i¢ter~builder <br />( ) The ~rk W/Ii be pe~orm~ by a r~i¢tered builder <br />( ) / am performing ~rk on a property I own or occupy <br />( ) Other (please <br /> <br /> --y <br />I have rind th/~ appb~atlon in its entirety and certi~tho toted /nformation is true and carrot to the best of my knowl~ <br /> <br /> PLEASE N~DrJveway and sidewalk insp~M are required by Public Works: 588'5036 Other permits required by,bls dept: Plumbing ~ Electrical~ <br /> <br /> <br />