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MARION COUNTY <br /> DEPT. OF BUILDING INSPECTION <br /> ~tor Building # 225 <br /> '220 High St., N.E. 2nd Floor <br /> Salem, Oregon 97301 <br />R-H. WITHROW. BLDG. ADMINISTRATOR <br />58~5147 -- 58~5148' <br />5;00 P_M,-- ...... COOE-A-Pho~e 6884S373 ........... 8:0~ A.M, <br /> <br />Address: <br /> <br />js,.~.:.~ ~:;VALUk2ION Oi~LY <br /> <br />81dr. & No.; Phone: <br /> <br />Plans by: P. hone: <br /> <br />Lot No: 81k. No: <br /> <br />Water Supplv: <br /> <br />,Sewage <br />Dbpo~al: <br /> <br />Sub dy. <br /> <br />A~ea of Bldg: <br /> <br />Tax Lo*: No; .... <br /> <br /> Sec, <br /> <br />Address;, , 10 , .~.a,17['. .D ....... <br /> <br />Heating <br />System: <br /> <br />Address: · <br /> <br />Address: <br /> <br />Lot Size <br /> <br />Valuation; <br /> <br />Site <br />Evah -- Permit Fee: <br /> <br />No- <br />Stodes; $1alte ~urcharge: <br />Roof <br />Type: Plans Chk. Fee: <br /> <br />Septic Permit Fee: <br /> <br />120.00 <br /> <br />BTU; Total Fees: <br /> <br />PLANS <br /> <br /> ~mlt ex~l~ if ~rk ~ot ~mme~ within f~ day& I furht~ exp~y warrant ~at I comply wi~ the p~vlslons Of <br /> 701. 125 <br />l am a ~kt~ ~lld~ or ( ) ~e au~ori~ r~re~n~at/v~ of a ~i~e~ butl~ <br /> <br />! ) 771~ Work will be paffOrrned by a reg/stere~ builder <br />{ ) I am performing WOI~ on a property I own or occupy <br />( ) Other (please ~ecify) <br /> <br />REMARKS; <br /> <br />PLEASE NOTE: DN~eway aNfsidewall< inspeCflO~are required by Public Works: <br /> Other permi~ required by This dept[ Plumbing [] Electrical <br /> <br /> <br />