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Appl.~ Revd;: ~ <br />By;; <br /> <br />Date: <br /> <br /> MARION COUNTY <br /> DEPT. OF BUILDING INSPECTION <br /> Senator Building # 225 ~ _/~_.~ <br /> 220 High St., N,,E,, 2nd Floor Permit No, , <br /> Salem, Oregon 97301 <br /> <br /> B88-$147 - 58B-514B <br />500 P,M,- .......... CODE-A-Phone 588.5373 ........... B::00 AM <br /> <br />Type of Permit;: Tax Lot No; _ <br />A ! ' . ' ~ Sec. __Twnshp, , Rge 'i= f <br /> <br />Owner;; Phone~ = ., Address: / , ~ - <br /> <br />BIdr. & No,,:: Phone: __ Address: <br /> <br /> Plans by:: Phone: Address:: <br /> M. p Pege .,~i,r~e ' ZoneChg 1 Part, Cond Use Variance Fire Tone I Occupancy .,~ypeofConst <br /> <br />Lot No;; , BIk, No;; <br /> <br />Sub dy, __ Lot Size Corner? <br /> <br />Water Supply:; <br /> <br />Sewage Site <br />Disposal:; : Eval; <br /> No. <br />Area of Bldg: ~ Stories:_ <br /> Roof <br />Basement: Type:: <br />Heating <br />System:: ; <br /> <br />BTU ;; <br /> <br />VALIDATIONS:: <br /> <br />Valuation: <br /> <br />Permit Fee;; <br /> <br />State Surcharge;; <br /> <br />Plans Chk, Fee: <br /> <br /> ,, <br />Septic Permit Fee: <br /> ,: _,., <br />Total Fees; .! r~o :. <br /> <br />Rcpt, No: <br /> <br />PLANS <br /> <br />I agree to build according to the submitted plans and specifications, the laws of the State o~ Ore,ion and the Orzdnanc,e$ofMarion <br />County, Permit expires if work not commenced within 120 days I furhter expressly warrant that I comply w~th the provisions of <br />701~5 to 701 125 because <br />( ) lamaregisteredbui/deror( ) theauthorizedrepresentativeofar~i~ter~bugder <br />( ) The work w~ll be performed by a r~tered builder <br />( ) Ium performing work on a property I own or occupy <br />[ ) Other (~/ease ~pec~fy) <br />REMARKS __ <br /> <br />PLEASE NOTE;: Driveway and sidewalk inspections are required by Public Works: 588-5036 <br />Other permits required by this dept:: Plumbing ~ Electrical [] <br /> <br /> <br />