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Appl, Revd: M0 NDA~ <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 />R,H: WiTHROW, BLDG. ADMINISTRATOR <br />588-5147 - 588-5148 <br />5:00 P.M,- ........... CODE-A-Phone 58B-5373 ......... 8;00 A,M. <br /> <br />%¸. <br /> <br /> Type of Permit: <br /> <br />Tax Lot No~ <br /> <br />By: , ., <br /> <br />Phone: 7~9-3446 <br /> <br />Phone: <br /> <br />phone: <br /> <br />Mop Page Zone I ZotleChg. J Part, I Cond, U~l Variance <br /> <br />Sec. ~ Twnshp.~ Rge, <br /> <br />Address:. <br /> <br /> Address; ~, <br /> <br /> Address; <br /> I Fire Zone" Occupancy I ' Type o{"Const," <br /> <br />Men Req. Front Sides Rear <br /> <br />Lot NO: BIk. No: Sub dy, : Lot Size ...... Corner? <br /> <br />Water Supply: Valuation: =, <br />Sewage Site <br />Disposal; ~ Evah Permit Fee: _ lLano0 <br /> No, <br />Area of BIdg; ~¢~Q ~ ¢'"h Stories: _ State Surcharge; <br /> Roof <br />Basement; Type: ~ r ;' ' '" Plans Chk. Fee: <br />Heetln~ <br /> <br />BTU; ~II <br /> <br />Total Fees: 2~g~'g8 <br />.cpt. No; -~~ <br /> <br />VALIDATIONS: <br />ZONING SEPTIC TANK PLANS ~ <br />~v'. By: Ely: ~ ~ <br /> <br />C~nty. Permit exp/res if work not commenc~ within 120 days, I furhter expressly warrant ¢hat I comply w/th the prov~s[on~ of O~S <br />70I.~5 to 701. 12E because; <br />[ ) /amar~isteredbul/deror( / theauthor/z~repfesentetiveofer~ister~bui/der <br />( ) Theworkw/l/bepadorm~byar~/ster~builder <br />{ ) I~mperform/~workonaprope~ylownoroccupy / / /~ <br /> <br />I have read this application in its entirety and certify that the St~tecl information is true and correct to the best of/ny knowledEe. <br /> <br /> PLEASE nOt~2Dr~wa~Jk inspeCtions ar~ required by Public Works: 5.8-5036 Other permits required by this dept: Plumbin~ ~ ~lectrical ~ <br /> <br /> <br />