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MARION COUNTY <br /> BUILDING INSPECTION <br />Senator Building * 220 High S:reet NE · Second Floor · Salem. Oregon 97301-3670 <br />Office Hours: 8t~- 4:3(I Phol~: 588-5147 24 Hoar Co&e-A-Phone: 588-7904 <br /> <br /> ~AmI~T.I'C~T¥ON FOR EXEMPT <br /> <br /> this property c~a~ified as far~ do~orral by th* Ration County <br />showLn~ the farm d~f~rral.) Y__ N ~ <br /> <br />you located within the urban Growth Boundary? Y <br />D~scribes~ructur~.~n~a~l~ ~us~~r co~odit~es~ ~st°r~d~--~i~ %he propo,ed <br /> ~:l l~l~ ....... <br /> <br />IS the proposed structure losated within a flood plain? Y N~ <br /> <br />Does the proposed structure have any of the following systems? <br />Electrical ~ Plumbing ~ Heating/Cooling/Ventilation ~ <br />Where will res:room facilities be provided? ~ <br /> <br />will persons be working in the struoture ~ore than a total of 144 hours, <br />durieg any week of the year? Y N <br /> <br />Is this structure used by the public at any time? Y N~ <br />Explain: <br /> <br />This application will not be considered complete without a site plan. <br />See attached site plan requirements. <br /> <br />10. What is the distance from the proposed structure to property lines <br /> and/or other structures? Front Left side ~m~ <br /> Right Side w~ O Rear ~ other structures ./;~ <br /> <br />I certify that I have read this application and state that the information <br />given is correct. I agree to comply with all state laws and county ordinances <br /> <br />relating to building construction. <br />SIGNATURE <br /> <br />PHONE <br /> <br />NAMF~ (please~ pMint ~ /~% I <br /> <br />CITY STATE ZIP <br /> <br />Planning Division Validation By: j_~:c~.,'. DATE: / <br />COMMENTS: <br /> <br /> ~, ) ....... ~==. .... ~ ....... <br /> <br />7/91 <br /> <br />~*~'PROIFED: DENIED: STRUCTURAL PE~ IS REQUIRED <br /> <br /> other permits required: Electrical, Plumbing, Mechanical, Septic <br /> <br /> <br />