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Appl. Revd: <br /> <br />By: <br /> <br />Date:; 6-20-80 <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 588-5373 ........... 800 A,M,, <br /> <br />Type of Permit; <br /> <br />SI'±'L E¢,LU,,,TIO~'~ O~LY <br /> <br />Owner;; dO,~ ~,,i ~SC~I~{ Phone;; 7A9-2917 Address;; <br /> <br />Bldr & No.;; <br />Plans by:: <br /> <br />__ Phone::__ Address:: <br /> <br /> Phone: Address: <br /> <br />Tax Lot No:: <br /> <br /> 24~ Twnshp,, ¢~s Rge <br /> <br /> 8918 SH~,&~ <br /> <br />2w <br /> <br />~7325 <br /> <br /> Msp??ee Zone Cha, <br /> <br />Use of Bldg :; ~N¢ ecl~m~ Min Req, Front <br /> Setback~ <br /> <br />Occuoancy I Type of Const <br /> Sides J Rear <br /> <br />Lot No: <br /> <br />Water Supply;; <br /> <br />Sewage <br />Disposal:: <br /> <br />Area of Bide; <br /> <br />Basement: <br /> <br />Heating <br />System:: <br /> <br />BTU: <br /> <br />BIk. No: Sub dy,, <br /> <br /> Valuation;; <br /> <br />Site <br />Eval ;: Permit Fee:: <br />No, <br />Stories;: State Surcharge: <br />Roof <br />Type: Plans Chk. Fee;; <br /> <br />Lot Size 3 ,~C Corner? <br /> <br />Septic Permit Fee:: <br /> <br />Total Fees: <br /> <br />VALIDATIONS1 ~/~ ~ <br />ZONING ~ SEPTIC ]~)(N.~..i~ _ PLANS <br /> <br /> By:; /~' , ~ ,i ~.~ ~ By ~/ ( J~~ 8~y: <br /> <br />I agree to build according to the submitted plans and sp~ifiCatiOns, the laws of the State of Or.on and ~e OHdnances of Mar~on <br />County Permit expikes if work not commenced wlthln 120 days I furhter expressly warrant t~gt / comply with the p~ow,~/on,s of ORS <br />ZO 1 005 to ZO 1 125 because <br /> <br />( ) lamaregisteredbuilderor( ) theauthorizedrepresentativeofar~isteredbui/der <br />( ) The work will be pe/orm~ by a registered builder <br />( ) / am pe~fom~ihg work on a propgrty I own or occupy <br />( ) Other (p/ease ~ify) <br /> <br />I have read thi~ application in i'ts entirety and certify that the stated information /S true and correct to the beat of rrly know/edge <br /> <br /> PLEASE N~E Driveway and sidewalk inspections are required by Public Works: 588-5036 <br /> Other permits required by this dept: Plumbing ~ Electrical ~ <br /> <br /> <br />