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AppL Recd~ Monc~a~ .- <br />Data-' <br /> <br /> MARION COUNTY <br /> DEFT. OF BUILDING INSPECTION <br /> ~nator I~uiidlng # 225 ~ ~ ,, <br /> ~lem, Oregon g7~1 <br /> /~ - <br /> <br /> ~/8~ 5:00 P,M.- .......... CODE-A-Phone ~8.5373 .......... 8:00 A.M. Date: <br /> ........ 2~ ',~ ~=~ <br /> <br /> , .... Twnshp, ~Rge ..... <br /> <br /> Squ~l <br /> .... ~ s~ea <br />83dr. · No.: ~Ei2~ ~one: ,, , Add~: __ · <br />Pi~n~ by: ~one: Add~: <br />$8 AR <br /> / ,IO <br /> ....... , ....... ~.~ <br /> <br />Lot N~,~_. ~lk. No,~ ~ .... <br /> <br />~in Rt.: ~ Flr,~ .... Valuation: <br /> <br />Septic Tonk <br /> <br />System= .... Plumb. ~., <br />VALIDAT~O~S~ su~hotge !'~ <br />~te,~~ ~ ...... __ P~n~ Chk. fee, <br /> <br />I ague ~ build according to fha ~ubmltfed ~.~ and ~8~a~i~n~, the law~ of t~e Sta~ ~EQ Sur~rge~ <br />of ~egon and the O~inances of Marion Count, Permit expires if work not com~nced ~OTAL FEE~~ <br />wi~m ~80 d~ys, I ~rther exp~ess/y worrant thor ~ ~mpJy w~ the provlsion¢ of ORS <br />701,O05toTOl. I25~ause~ <br />( ) ~ ~ per~emlng work on a p~p~rty I own or occup~ RECEI~ NO.~ <br />( ) I om 0 regls~d builder OR ( ) the outhoH~ed ( ) ThO wo~ w~jl ~ peHo~ by a ~g~tered b~der <br /> te~esen~tive oF a regismred builder ( ) O~r (pl~e ,~ci~) ~ ~ ~ ~ ~ ~ ~ . <br /> <br />REMARKS <br /> <br />I have read ttff$ application [n its <br /> <br />end certify that the $~ated informal/on i$ ~rue and <br /> <br />SIGNATURE OF APP <br /> <br /> PLEASE <br /> <br />and sidewalk inspections are required by Publie WorRs: 588-5036 ~.~ <br />Other permits required by this dep~:: PJumbing [] i:lectri*..al [~ <br /> <br /> <br />