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AppL Revd'- <br /> <br />Date: 2.2/82 <br /> <br /> MARION COUNTY <br /> DEPT. OF BUILDING INSPECTION <br /> Senator Building # 22S <br /> 220 High St., N.E. 2nd Floor <br /> Salem. Oregon 97301 <br /> <br /> 588.5147 - 588,5148 <br />5;00 P,M_. ......... CODE-A-Phone 588.5373 ........... 8:00 A.M. <br /> <br />Permit I~1o.. ~__ <br /> <br />Type of <br />Owner: ~t~lle Co~. Ch. ~: 678-~88 <br /> <br />Tax Lot No: ~-~)00 <br /> <br /> S~ <br /> <br />Address: <br /> <br />Plans by: Phone: Address; <br /> Ma, fa~e 1 ~. I 2°'~dl~,~-=~'"~"'~(. I Cema. Lke I V, rla,~ 1I~i~e Zoo. i Occu~ I TV~ Co-~- <br /> <br />Lot No; .BIk. No: Sub dw. <br /> <br />Lot Size 210/220 Corner? <br /> <br />Water Supply: <br />Sewage <br />Disposal: <br /> No. <br />~a of 8t~; Stori~; <br /> Root; <br />8a~nt: Ty~: <br />Heating <br />S~m; <br /> <br />Valuation: <br />Permit Fee: 50.00 <br />State Surcharge; 2.00 <br />Plans Chk. Fee: <br />Septic Permit Fee: <br /> <br />BTU: <br /> <br />VA LI OAT lO,NS: <br />ZONING <br /> <br />Total Fees: 102.00 <br /> <br /> PLANS <br /> <br />agree te build accord/nE :o the subm/Z-te~ ~/atTs and ~ciflcatio/~r, ~ /aw~ of the State of O~fl a~ ~e Or~nan~w Of M~n <br />C~nw_ ~rmJt exp~e~ if ~k not comme~ w~i~ 1~ ~y~ / fu~ ex~y waist ~t i c~ply with ~e p~vlslo~a of ORS <br />701.~5 to 701,125 <br /> } lama~i~builderor( ) ~e~ffior~z~re~ti~Ofar~i~r~fluild~ <br /> ) The ~ will ~ pe~m~ by ~ ~8~ fi~ild~ <br /> ) I am p~or~l~ ~ on a pro~ { o~ or ~cupy <br /> ) O~h~ (pi~ <br /> <br />REMARKC: <br /> <br />/ have read thia application in ir~ e/l~/re~y and certify tha: ~he sta~ [nforma~lo~ is true ~d c~t to ~e ~st ef my knowl~ge. <br /> <br />SIGNATURE OF APPLICANT: ,, <br /> PLEASE NOTE; Drip'nd s~~ions are ~uir~ by Public Works: 588.~36 <br /> Other ~rmlts r~ui~ by <br /> <br /> <br />