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MARION COUNTY <br /> DEPT, OF BUILDING INSPECTION <br /> Senator Building # 226 <br /> 220 High St., N.E. 2nd Floor <br /> Salem, Oregon 97301 <br />R.H. WITHROW, BLDG. ADMINISTRATOR <br />588-5147 - 588-5148 <br /> <br />Permit No. ?('~-- c~?~-/ <br />By: ~ .......... <br /> <br />Date: <br /> <br />Address~ ~~~, ~,~ Sec../¢ Twnshp. ~._Rge. / ~ <br />Owner: _.~ ¢/~, Phone~ S~ Address'. ~ / ~C.,.,.,,,...~ <br /> <br />Bldr, ~ No.: ~ Phone: Address: <br /> <br />Plans by: Phone: Address; <br />Map Page Zone Chg. Pa~t. Fire Zone 'Type of Const. <br /> <br />Lot <br /> NO: <br /> -- __,BIk. No: Sub dv ....... Lot Size~Corner? <br />Water Supply; -~~ Valuation: $ <br />Sewage <br />Disposal; ~¢ Site <br /> No. <br />Area of BidE; ~..~D Stories: State Surcharge: ~ , 00 <br /> <br />Basement; Type; Plans Chk. Fee: <br />Heating <br />System; Septic Permit Fee: .......... <br /> Tota[ Fees; //~, <br /> <br />R'ru: <br /> <br />I ~gree fo build accord/nE to the submltt~d plans and specifications, the laws of the State of OraEon and the Ord/nance$ of M~rioo <br />County, Permit eXplTea if work not~ ~'c°~menc~ w/,thiR l2O days. ~ <br />SIGNATURE OF APPLICANT: <br /> <br /> ~,_~.oi~ bus~ness as described <br /> Yegiste~ed bu~]deP puPsuant to the above Statute. <br /> <br />PLEASE NOTE: Driveway and sidewalk inspections are required by Public Works: 588-5936 <br />Other permits required by this dept: Plumbing ~ Electrical [] <br /> <br /> <br />