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ppf eod <br />By:: . P ATq~' <br />Date: <br /> <br /> MARION COUNTY <br /> DEPT. OF BUILDING INSPECTION <br /> Senator Building #225 <br /> 220 High St, NE 2nd Floor <br /> Salem, Oregon 97301 <br /> <br /> 588-5147 -- 588~5148 <br />5 00 PM ................CODE-A-Phone ............... 8::00 A M <br /> <br />Permit No :: <br /> <br />Type of Permit: D[:~,I~FTC~3~,D [:~!~AIR <br /> <br />Address 538'7 ]TJ't4.D~E~ DR ~B AOMSV'~'B <br /> <br />Owner:: <br /> <br />Bldr & No ::~~TTC <br /> <br />Phone:: <br /> <br />Phone:: <br /> <br />378-7454 <br /> <br />Address::_ <br /> <br /> BOX 3818 g9~02 <br />Address ~o <br /> <br />Plans by Phone: <br /> <br />Address;: ........ <br /> <br /> M a~.~eI Zone I ZoneChange part Oond Use variance~edj <br /> <br />Use of Bldg No adrms Min Req <br /> <br /> ~;E~$DENCE or Ccc Ld ~3 Setbacks <br /> <br />FT/FD ,J Occupancy Type of Const <br /> <br /> Front ,[ Sides Rear <br /> <br />Lot No..:; . Elk. No..:: Sub. dy..:: ........... <br />Area of Bldg 2nd Rase- Total <br /> <br />Main Fir .Fir..' __ merit .. Area:: <br /> <br />Roof Type: Tr uss/Stic k::~ eig hr;: ,,, <br />Heating Wood Water <br />System Stove:: Supply:: <br />Septic Tank New <br />Site Evel :: .Instal,:: <br />Exist No <br />System .Gals:: 1000 gallon~ <br /> <br />VALIDATIONS <br />Zomng Mechanical. <br />Date:: ~)__ .Date:: <br />SepticTanl~/..~t~ -~([ j~[_ Plans:: <br />Date:: .l~.J - .~ '~]. ~-~ ~ Cate:: ~ <br /> <br />I_ot Size:: ~ AC <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, <br /> <br />Corner?~ ~ <br /> <br />[5..,po <br /> <br />I agree to build according to the submitted plan3 and specihcatlona, the laws of the <br />State of Oregon and the Ordinances of Marion County. PERMIT EXPIRES IF WORK <br />NO T COMMENCED WITHIN 180 DA YS I further expressly warrant that I comply with <br />the provisions of ORS 701005 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 (please specify) <br /> <br />DEQ Surcharge:: <br /> <br />TOTAL FEE <br />BLDG <br />RECEIPT NO:: ~ <br />Driveway <br />Permit Fee;: __ <br />S~te Plan <br />Review Fee::. <br />Public Works <br />Receipt No:: <br /> <br />I have read this application in its entirety and certify that the stated information is true end co__est of m~/~ledge <br /> <br /> PLEASE NOTE:: Driveway and sidew~ired by PutShe Wor~s 588-50~6 <br /> Other permits required by this dept:: Plumbing 0 Electrical ~ Mechanical B 7¢¢~ ~ <br /> <br /> <br />