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AppI. Recd
<br />
<br />By: C~ris
<br />
<br /> MARl(: COUNTY
<br />DEPT. OF BUILDING INSPECTION
<br />Senator Building #225
<br />220 High St,, N.E. 2ad Floor
<br /> Salem, Oregon 97301
<br />
<br /> 588-5147 -- 588~5148
<br />
<br />Permit No.; R6~467
<br /> alee. #2956
<br /> Prttg --
<br />
<br /> 5:00 P,M ....................... CODE-A-Phone ...................... 8:00 A.M,
<br />Date: 5-?,,3-86 Date;
<br />
<br />Type of Permit: .... _~L~bi!e Home P1,Bcament -,~,dequ.-'*~' ,e--ow ~4 %iT~ L.~C~Xt¢.~- 1-,=nk ,
<br />
<br />Bldr,& No,: Bill Srumb,-~ugh$
<br />Plans by:
<br />
<br />__Phone:_, 678-5939 Address: 'f2473 F,-y t,,~4, fc~
<br />
<br /> Phone:_ 263-6208 , Address: !]r~!? ~q., 1~'¢-w :~*-., ;,}¢,
<br /> Phone: Address:
<br />
<br />6
<br />
<br />Lot No.: ,,, BIk. No.' ,, Sub. dv.: ,
<br />Area of BIdg, 2nd Base- Totat
<br />
<br /> Bldg. Permit 50 o00
<br />Roof Type:. Truss/Stick; , Height: Fee; (+ 5%) .,, 2 ..5,0
<br />Heating Wood Water
<br />System: , Stove: Supply; w~ 1_ Elect. Fee: .,, A~.t~e~
<br />Septic Tank New
<br />Site Eval.: __ __Instal.;
<br />Exist, No,
<br />System: yr%e Gals.;
<br />
<br />1,000
<br />
<br />VALIDATfONS:
<br />
<br />I agree to build according to the submitted pla'nO'sand specifications, the laws of the
<br />State of Oregon and the Ordinances of Marion County. PERMIT EXPIRES IF WORK
<br />NOT COMMENCED WITHIN 180 DA YS, I further expressly warraot that I comply with
<br />the provisions of O~S 701.005 to 701. 125 because:
<br />
<br />( ) I am pe~'forrnil'~g work on a property I own
<br /> Or OCcupy
<br />( ) I am a registered builder OR ( )ttTe
<br /> authorized representative of a
<br /> registered builder
<br />
<br />REMARKS!
<br />
<br />I_ot Size:__ g 1 5_~_~! t E;orner? no
<br />
<br />Mech. Fee;.
<br />
<br />Plumb. Fee; ,,
<br />State
<br />Surcharge; (40/0) 3.60
<br />
<br />Plans Chk, Fee:
<br />Septic Tank
<br />Permit Fee: ..
<br />
<br />DEQ Surcharge:
<br />
<br /> TOTALFEE: 161.10 /~ .(//.~
<br /> BLDG.
<br /> RECEIPT NO.; ~~
<br />) The work will be performed Driveway
<br />by a registered bu;Ider Permit Fee:
<br />) Other (please apectfy) Site Plan
<br /> Review Fee;
<br /> Public Works
<br /> Receipt NO.:
<br />
<br />SIGNAI'tJRE
<br />
<br /> Other permits required by this dept: Plumbing [] Electrical m Mechanical
<br />
<br />
<br />
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