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AppI Reed TUESD~ <br />Date;; 2-8-8,~ <br /> <br /> MARION COUNTY <br /> DEPT. OF BUILDING INSPECTION <br /> Senator Building # 225 <br /> 220 High St., N.E,, 2nd Floor <br /> sarem, Oregon 97301 <br /> <br /> 588-5147 -- 588-5148 <br />PM- ........... CODE-A-Phone 588-5373 ........... 8:00 AM, <br /> <br /> MOBILE HOME PLACEMEh~ ADEQUACY FOR HARDSHIP~Tax Lot No: <br /> <br />~2122 Fry ~o,:,]~ h. ~. _~uror~ <br /> Sec, 21 <br /> <br />Type of Permit: <br /> <br />Bldr, & NO" S]~' Phone;: Address: <br />Plans by:: <br /> <br /> Phone: <br />[~mr~ Cond, Use <br />,, <br /> <br />Lot No.:: ...... BIk, No,: Sub dv. <br />Area of Bldg. 2nd Base- <br />Main Fir,4 Fir.:: menh <br /> <br />Roof Type~ Truss / Stick: <br />Heating Wood <br />System: Stave: <br />Septic Tank New <br />S~te Evah Instal · __ <br />Ex,st, No <br />System~ ~ __ Gals.:: <br /> <br />Water <br />Supply~ <br /> <br /> Permit No. <br /> <br /> ~ 40857-000 <br /> <br />--.Twnshp, 4~ Rge <br /> <br /> 97O02 <br /> <br />Address: <br /> <br /> Variance File Zone O.~u,panc¥ ] Type of Const <br /> <br /> ~~ ~~ ~orner?. ~O <br />Total <br />Area: ]0 z 55 Valuatiom __ <br /> <br />VALIDATIONS:: <br />Zoning~ ,~ ,~ ~/~;/~ t~ Mechanical: <br />Dote:: j,)~,,I.O/__~_~ Date ......... <br />Date:: ~_~.~-~ ~ Date ..... <br /> <br />I agree to budd according to the submitted plans and specifications, the lows of the State <br />of Oregon and the Ordinances of Marion County Permit expires if work not commenced <br />within 180 days I further expressly warrant that I comply with the provisions of ORS <br />701,005 to 701 125 because <br />( ) I am performing work on o property I awn or occupy <br /> <br />) I am o rag,stared builder OR ( ) the authorized <br /> representahve of a registered builder <br /> <br />Elect,, Fee~ 1 .. t_ 0 <br /> <br />Mech,, Fee: . <br /> <br />Plumb Fee ...... <br />State <br />Surcharge~ ~' ~ ~ 0 <br /> <br />Plans Chk. Fee~ <br />Septic Tank <br />Permit Fee~ <br /> <br />DEQ Surcharge~ ~ <br /> <br />TOTAL FEE: i'3~ ._' .~._,~. <br /> <br /> RECEIPT NO ...... ~"~'-~' <br />( ) The work will be performed by a registered builder <br />( ) Other (please specify) <br /> <br />REMARKS <br /> <br />PLI~ASE NOTE: Driveway and sidewalk Jr~ections are required by Public Works: 588-5036 <br />Other permits reguired by this dept Plumbing [] Electrical ~ <br /> <br /> <br />