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Appl. cd: <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 /> <br /> 588-5147 - 588-5148 <br />5:00 P.M.- ........... CODE-A-Phone 588-5373 ........... 8:00 A.M. <br /> <br /> 416 <br />Permit No. <br /> <br />Dottle <br /> <br />Date: 4/29/83 <br /> <br />Owner: A'~',(,// ~- Phone: Address: // Lq ~;~df"?- ~ ~' <br /> <br />Bidr. & No ' Phone: Address: <br /> <br /> Map P~e ~ Zone Zone Chg, "'~art Cored. U~ Veri~nce Fire Zone Occupencv <br /> <br /> No Bdrm~, Min R~, Front Sides <br />U~ of ~ldg,: or 0¢c, Ld; ~etbacks: <br /> <br />Type of Const, <br /> <br /> ,,, __ Lot Siz&--- <br /> 2nd B~se- Total <br />Area of Bldg,.~_~,/~ <br />Main Fir.- , ) ?~ Fir.: ment: .... Area- Valuation: <br /> Bldg, Permit <br />goo~ Type: /~ (~-~ Truss/Stick: Fee; (+ <br /> <br />Heating <br />System~ <br />Septic Tank New <br />Site Evab ............... Instal.:. <br />Fxi¢, No. <br />System:. Gals - <br /> <br />Wood Water <br />....... Stove, Supply: Elect. Fee: <br /> <br />VALIDATIONS: <br />Zoning: Mechanlcah <br />Date;. Date: <br /> <br />Septic Tank: <br />Date: ....................... <br /> <br />I agree to build according to the submitted plans and specifications, the laws of the Sta~ <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 own or occupy <br />()('} I om a registered builder OR ( ) the authorized <br /> representative of a registered builder ( <br /> <br />Mech, Eec;. <br /> <br />Plumb. Fee: ................ <br />State <br />Surcharge: <br /> <br />Plans Chk, Fee;__~'-~-~-'?-_'--L2 <br />SepHc Tank <br />Permit Fee: <br /> <br />TOTAL EEE: <br /> <br /> RECEIPT NO.~ <br />) The work will be performed by a registered builder <br />) Other (please specify) <br /> <br />REMARKS: <br /> <br />I Ila¢e read tht~ app/tbatlon in i~~~ true and correct to the best of my know/edge. <br /> <br />SIGNATURE OF APPLICANT: ......... ~ ........... <br /> PLEASE NOTE: Driveway and sidewalk inspections aPe required by Public Works: 588-5036 <br /> Other permits required by this dept: Plumbing [] Electrical <br /> <br /> <br />