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PATI~ <br /> <br /> SITE I?AIIIATIOI~ OIILY <br /> <br /> MARION COUNTY <br />DEPT. OF BUILDING INSPECTION <br /> SenaTor Building # 225 <br /> 220 High St., N.E. 2nd Floor <br /> Salem, Ol~egon 97301 <br /> <br /> 588-5147 - 588-5148 <br />5:00 P.M,- ..... COoE.A.Phor~ 588-5373 ........ 8;00 A.M. <br /> <br />Type of Permit: <br />Addre~s~ 8~21 I~OLMO~IIzST ~ SE <br /> <br />Owner; <br /> <br />Phone: <br /> <br /> ~ <br /> 56361-815 56362-000 <br /> ,,Tax Lot No: <br /> <br /> sec. 31 Twr~p. 8..~, 1~ <br />~:~ ~ ~[ ~95 s~A~a 97383 <br /> <br />Address; <br /> <br />bat No.: 5 $1k. No., Sub d- ....... <br />A~eo of Bldg. 2nd <br />Moln Fk.l~ Rr.: .... men~* <br /> <br />Total <br /> <br />Roof Type: Truss/Stick- <br />Heatinla wood <br />System, Stove~ ,, <br />Septic Tank New <br />Site Evah <br />Exist. No. <br />Sy~h~m. Gals.- <br /> <br />Wete~ <br />Supply~ <br /> <br />I og~e ~o build according to the submitted plans and specifications, the laws of <br />of C~ and the Ordinancea of Marian Courtly. Permit exp/~e~ if work nat commenced <br />within 180 day~. I further expressly war~ant that I comply with the pcev;si,snf ef ORS <br />701.005 k> 70 I. 125 because; <br />( ) I am performing work on o proper~y I own ~r occupy <br />( ) I om o registered builder OR ( ) the authorized <br /> representer/ye of o r~giffered builder <br /> <br />2.86 C~,~r?. ,,, SO <br /> <br /> TOTAL FEE- 11 <br /> <br /> RECEIPT NO. <br />The work will be performed by a registered builder <br /> <br /> ~0~: Th~ does not ;tc~t or 'imply <br /> <br />I haw~ resd rhi~ application in it~ entirety a~t~ Certify ~ltat ~e s~t~ in~atlon is true ~d c~t to ~e ~r of my k~wl~e, <br /> <br />SIGNATURE OF APPLICANt. _ .~ ~ <br /> PLEASE NOTE; Driveway a~ sidewalk ink.ions a~ r~uir~ by Public Works: 5~-~36 <br /> <br /> Other ~rmJts r~uir~ by this dept: Plumbi~ ~ E~ectri~l ~ <br /> <br /> <br />