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Appio Revd: <br /> <br />By: ~ ,, <br /> <br /> MARION COUNTY <br />DEPT. OF BUILDING iNSPECTION <br /> · ~enator I~uiiding #225 <br /> 220 High ~,~ N.B. 2nd F~oor <br /> Salem, Oregon 97301 <br />R.H. WITHROW, BLDG. ADMINISTRATOR <br /> 588-5147 -- 588.5148 <br /> <br />Ad,quincy Check <br /> <br />Lot No: _BIk. No~ IL <br /> <br />Valuation: <br /> <br />Permit Fee: <br /> <br />State Surcharge: , <br /> <br />Plans Chk. Fee: <br /> <br />~epti0 Permit Fee: <br /> <br />Total Fees: <br /> <br />Rcpt No; <br /> <br />Sewa~le j ..... Site <br />Disposal: ~ Eval: <br />Area of Bldg: ~ 8tc'rie~; <br /> <br />Basement; <br />Heating ~ . <br />System: ~ ~'~ <br /> <br />BTU: <br /> <br />VALIDATIONS; T~~,, <br />ZONING SEPTIC PLANS <br /> <br />C~n~, Permit explre~ if ~rk not ~mm~ wi~i~ 1~ Earl, i furh~ exDte~y warr~t ~a~ i c~p/y with ~e provisionsof ORS <br />701.~5 to 70L 12~ <br />( ] lamar~is~r~builderor( ) ~eau~Ofi~fe~fltativeofar~is~e~bui/der <br />{ ) ~e ~rk will be pedorm~ by a f~i~ ~uild~ <br />( ) I am p~formi~ ~rk on ~ p~pe~ I ow~ or ~cupy <br /> <br />I have read this a~pll~ation in its entirety and certify tha~ the $~ataY I~formation i~ ~ue and corr~t ~0 the ~=t of my k~wl~ge. <br /> Other ~rmlts rNui~ by this dept: Plumbing ~ El~rigal ~ <br /> <br /> <br />