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· ~E~T~ ~ BI.[ILBIN~ INSPECTION <br /> · ' ~ J ~/j~enator I~ulldln,g,#225 <br /> , ~ ~ High ~t.. N.E. 2nd FI~ Permit No,: ~ <br />.'"";" JUN <br /> <br />BJdr. & Ne.: Phone; Address: <br /> <br />Area of I~I~g, 2nd Base- Total <br />Main Fir,; ,Fir,; ,,, merit: Area: <br /> <br />Root Tyge: Truas/$ticl<: Height:,,, <br />Heating Weed Water <br />System: ,~tove: , Supply: ...... <br />Septic Tank .1 ~.. New <br />Site EvsI.: ~ .'~ ..... Instal.: ....... <br />Exf~t, NO. <br /> <br />VALIDATIONS; <br />Zon;ng; Mechanical; <br />Date: _,. ~ ~/ Date:,, , <br /> <br />I agree to build according to the submitted plan8 a~d epecificeHo~$, the law~ of the <br />5tats of Ore~o~ and the Ordinances Of Marion County. PERMIT EXPIRE~ IF WORK <br />NO T COMMENCED WI 7HIN 180 DA YS. I further expressly warrant that I comply with <br />the prOv/s/on~ of ORS 701.005 to 701,125 becauee: <br /> <br />(~1 am performln~ work on a property I own ( ) The work will be ~formed <br /> or oecupy by a fegiste~ builder <br />( ] 1 ~m ~ registered builder OR { ] the ( ~ Other (please <br /> authorized ~preaentative of a <br /> registered builder <br /> <br />Valuation: <br />Blclg. Permit <br />Fee: (+ 5%) <br /> <br />Elect. Fee; <br /> <br />Mech. Fee: ,,, <br /> <br />Plumb. Fao:. <br />State <br />Surcharge: (4%} <br /> <br />Plans Chk, Fee:, ,, <br />Septic TaDk <br />Permit Fee: <br /> <br />DEQ Surcharge: , ~ ~ ('3) <br /> <br />BLDG. <br />RECEI~T HO.: ..... <br />Drivewa~ <br />Permit Fee: <br />Site Plan <br />Review Fee~ <br />Public Works <br />Receipt No,: <br /> <br />R~MARKS: <br /> <br />I have read th/a application in/t~f~tlrety and certify ti~t the stated inter, t/on is true and correct to the best of my know/edge. <br /> <br /> ~LEAS~ NOT~: Driveway end sidewalk ~:~ectlon ~re required by P~blic W~rk~; 588-5056 <br /> O~her permits required by this dept; Plumbing 0 Electrical 0 Meohanica~ 0 <br /> <br /> <br />