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ApI~. Recd.: <br /> <br />By' Chris <br />Bate: 8-18-86 <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.: 86-584 <br />By: Patty <br />Date: 8-22-86 <br /> <br />Type of Permit: Repair Permit - drainf~ld <br /> <br />Tax Lot No' <br /> <br />Address: <br />Owner: <br /> <br /> 2057_1 Boones Ferry ..Rd. NE %~ec.: 15 Twnshp.: t4s Rge,: lw <br /> ~c~v/ <br />~rt~n ~ Nancy Clxrk__Phone: 678-2514k~' Addrese: P.O. 50× ]68 zkurora 97002 <br /> <br />BIdr. & No.: <br /> <br />Phone: Address: <br /> <br />Plans by; __ Phone: Address; <br /> Map Page Zone Zone Change Pczrt. Cored, USO Variance/Adj. FT/FD Occupancy Type of Const. <br /> <br /> Use of Bldg.: } M~n Req. Front Sides near <br /> Re s. : 4 I Setbacks: <br /> <br />Lot No.' BIk. No.: ....... ,Sub. dy.: <br />Area of Bldg. 2nd Base- Total <br />Main Fir.; .Fir.: ment: AreA: ... <br /> <br />Roof Type: Truss/Stick' Height: <br />Heating Wood Water <br />System: Stove: Supply: ~:~!! <br />Septic Tank New <br />Site Eval.: ,instal.: <br />Exist, No, <br />System: y~ .Ga~s.: 1 ~ ~(1¢1 <br /> <br />VALIDATIONS: <br />Zoning: Mechan~cah <br />Date: , Date: <br />Septic Tank: F,~'/ ~,~ 2~¢, Plans: <br />Date: ,~xJ ~l-- Date: <br /> <br />I agree to build according to the submitted plans and specifications, the laws of the <br />State of Oregon end the Ordinances of Marion County. PERMIT EXPIRES IF WORK <br />NOT COMMENCED WITHIN 180 DA YS. I further expreeely warrant that I comply with <br />the provieione of ORS 701,005 to 701,125 because: <br /> <br />) I am performing work on a property I own <br /> or occupy <br />) I am a registered builder OR ( ) the <br />authorized representative of a <br />.~, registered builder <br /> <br />( ) The work will be performed <br /> by a registered builder <br />( ) Other (p/ease specify) <br /> <br />Lot Size' 7ac Corner? <br /> <br />Valuation:. <br />Bldg. Permit <br />Fee: (+ 5%) <br /> <br />Elect. Fee: <br /> <br />Mech, Fee: <br /> <br />Plumb, Fee: <br />State <br />Surcharge: (4%) <br /> <br />Plans Chk. Fee: <br />Septic Tank <br />Permit Fee: 35.00 <br /> <br />DEQ Surcharge; <br /> <br />TOTAL FEE: 35 <br />BLDG. <br />RECEIPT NO,; _ ~__~ <br />Driveway <br />Permit Fee: · <br />Site Plan <br />Review Fee: <br />Public Works <br />Receipt No.: <br /> <br />REMARKS: <br /> <br />I have read this application in its entirety and certify that the stated information is true and correct to the best of my know/edge, <br /> <br />SIGNATURE OF APPLICANT: <br /> <br /> PLEASE NOTE: Driveway and sidewalk inspection are required by Public Works: 588-5036 <br /> <br /> Other permits required by this dept,: Plumbing [] Electrical rq Mechanical E] <br /> <br /> <br />