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Appl. Recd' MONDAY <br /> <br /> PATTY <br />By: __ <br /> <br />Date: 3-1~-86 <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 ...................... 8:00 A.M. <br /> <br />Permit No,: <br /> <br />By: <br /> <br />Date; <br /> <br />Type of Permit: <br /> <br />Address: <br /> <br />Owner: <br /> <br />BIdr, & No,: <br /> <br />MOBILE HOFLE REPLACEF~iNT <br /> <br />11054 MILL CKESK RD SE <br /> <br />EDWARD B. WEAVER <br /> <br />SANTIAM MOBILE <br /> <br />AUMSViLL~ <br /> <br />Tax Lot No.: <br /> <br />.Phone:. none ..... Address; 3030 P~K AVE NE <br />.Phone; Address: _ I ' <br /> <br />SALEM 97303 <br /> <br />Plans by: <br /> <br />Phone: Address; <br /> <br />6 AC <br /> <br />~~o4 Zo~Change , Part. Cond. Use <br /> USO Of Bldg.: <br /> NC,, adrrn$, <br /> <br />Lot No.: .... Blk, No,: , Sub, dy,: <br />Area of Bldg, 2ed Base- <br />Main Fir.: __Fir,: __meet; <br /> <br />Roof Type; Truss/Stick;.. <br />Heating Wood <br />System: Stove: <br />Septic Tank New <br />Site EvaL: .instal,: <br />Exist. No. <br />System: YES ~Gals,: <br /> <br />Water <br />Supply; <br /> <br /> Lot Size: Corner?. <br />Total 12 × 60 <br />Area: Valuation; <br /> Bldg. Permit 35.00 <br />Height:. Fee: (+ 5%) 1.75 <br /> <br />WELL Elect. Fee: <br /> <br />103.71 <br /> <br />/.5 <br /> <br />Mech, Fee: <br /> <br />Plumb. Fee: <br />State <br />Surcharge:_.(4%) <br /> <br />SIGNATURE OF APPLICANT:/~~ <br /> PLEASE NOTE; Driveway and sidev~'alk inspection are required by Public Works: 588-5036 <br /> Other permits required by this dept.: Plumbing r"l Electrical ~ Mechanical [] <br /> <br />TOTAL FEE:_ <br />BLDG. <br />RECEIPT NO.: ..... <br />Driveway <br />Permit Fee: __ <br />Site Plan <br />Review Fee; <br />Public Works <br />Receipt No.: <br /> <br />( ) I am performing work on a property I own ( ) The work will be performed <br /> or occupy by a registered builder <br />( ) I am a registered builder OR ( ) the ( ) Other (please spec/fy) <br /> authorized representative of a <br /> registered builder <br /> <br />REMARKS: ~-----~/,-~'¢)~'A~ //'~'.~'~.~'"~d-~.. ,~/.,~tO~~'~ <br /> <br />VALIDATIONS: ~ 1.40 <br />Zoning: ~ _ ~ ~ Mechanical: fleet ~.56 <br />Date:_ ~/~7/~-(~ ~ate:_ Plans Chk, Fee: <br />Septic Tank' t/F] ~ ',-, -, ~, Plans' -,,-~/ --- <br />Date; 'Y4 , -~'~ ~'¢ Date:'~.~;~' ~ Septic Tank <br /> . ,,, Permit Fee: <br /> <br /> 5.00 <br />I agree to build according to tbs submitted plans and specifications, the laws of the DEQ Surcharge; <br />State of Oregon and the Ordinances of Marion County. PERMIT EXPIRES IF WORK <br />NOT COMMENCED WITHIN 180 DA YS. I further expressly warrant that I comply with <br />the provisions of ORS 701,005 tO 701,125 because: <br /> <br /> <br />