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'Appl. Rood ' <br /> <br /> MARION COUNTY <br /> DEPT. OF BUILDING INSPECTION <br /> Senator Bdiding #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 ...................... 8:00 A.M. <br /> <br />Bldr. & No,: _Phone: ....... Address: <br /> <br /> 475 <br />Permit NO.: <br /> <br />Dottle <br /> <br />Date: 9/16/86 , <br /> <br />_Twnshp.: Rge.: <br /> <br />Plans by: _Phone: ~.~_..._.~_.Aq d ross: <br /> MapPage 'l'" Zone ZoneOnange ............. Part~ --[ Cond. Use Variance/Ad,, FT/FD J Occupancy Type of Const. <br /> <br /> NO. Bdrms, Min Req. Front J Sides R~_a~. <br /> <br /> Total aF6 ' <br />Area of Bldg. 2nd Base- ~,~/¢.//~- <br />Main Fir.: .Fir.: ........ merit:. Area: ~ · Valuation: <br /> <br />Root Type: ,., Truss/Stick: Height: Fee: (+ 5%) <br /> <br />Heating Wood Water <br />System: ~/zO,C¢~' Stove: //'0/~(:~, Supply: /~/~'~/~' Elect, Fee: __ <br />Septic Tank ,~./O~ ~_~ New __. <br />Site Eval,: Instal.: Mech, Fee: <br />Exist... 1,/2 NO, ~,~- <br />System: /[/P ~v' k~, Gals.: Plumb. Fee; <br /> State <br />VALIDATIONS; Surcharge: (4%) <br />Zoning: Mechanical: <br /> <br />Date; _Date: <br />Septic Tank: Plans; ~/~.. <br />Date: _Date: z¢,.~ <br />I agree to build according to the s bm tt ~lans <br /> u i ed p aris and specifications, the laws of the <br />State of Oregon and the Ordinances of Marion County, PERMIT EXPIRES IF WORK <br />NO T COMMENCED WI THIN 180 DA YS. I further expressly warrant that i comply With <br />the provisions of ORS 701,005 to 701.125 because: <br /> <br />( ) I am performing work on a property I own <br /> or occupy <br />( ) I am a regiatered builder OR ( ) the <br /> authorized representative of a <br /> registered builder <br /> <br />REMARKS; <br /> <br />) The work will be performed <br /> by a registered builder <br /> <br /> BUILDING INSPECTION <br /> <br />Plans Chk. Fee: <br /> <br />TOTAL FEE; <br />BLDG, <br />RECEIPT NO,: __ <br />Driveway <br />Permit Fee: <br />Site 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 and correct to the best of my know/edge, <br /> <br />SIGNATURE OF APPLICANT: <br /> PLEASE NOTE; Driveway and sidewalk inspection are required by Public Works: 588-5036 <br /> <br /> Other permits required by this dept,; Plumbing [] Electrical [] Mechanical E;] <br /> <br /> <br />