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AppL Recd WEDNESDAY <br /> <br /> MARION COUNTY <br /> DEPT, OF BUILDING INSPECTION <br /> Senator Building #225 <br /> 220 High St~, N,E 2nd Floor <br /> Salem, Oregon 97301 <br />By' PA~Y By: Patty <br /> 588-5147 -- 588-5148 <br /> <br />Date',, 7-2..~84 $ 00 P,M ................. CODE-A-Phone ................ 800 AM. Date- 8-9-g4 <br /> <br />Permit No :: 84-1340 <br /> <br /> MO~,ITu~ HO~[; R~c~EJ~f"JT.~,~T & ~ AD~. 00083255 <br />Type of Permh , , __Tax Lot No <br /> 11~0 ~¢m.~ ~ S~~/~ ~) Sec-' 13,, Twnshp.. 9 Rge :_¢2W_ <br />Address <br /> <br />Owner ~E ~$~ .Phone: 769--7734 ddress:: 11460 ~LE~ ~NE SE <br /> <br />BIdr. & NO, , ,,,,~[~ ~g ~O~hone ....... Address:~ <br /> <br />VALIDATIONS <br /> <br /> Lot NO BIk NO. __Sub, dv Lot Slze__,100xl3S Corner?, , Y~;S <br /> Area of BIdg, 2nd Base- Tote] <br /> Mare Fir Fir ..... merit. Area 26x56 Valuation: <br /> Bldg Permit 50,00 <br />Roof Type Truss/Stick, Height;. Fee: (+ 5%) <br />Heating Wood Water <br />System Stove' __ Supply;: W~T.4~ Elect. Fee 20.00 <br />Septic Tank New <br />Site Eval, , . Instal. Mech, Fee, <br />Exist No <br />System, ~'~,.~ _Gala, ~ Plumb Fee <br /> State <br /> Surcharge:. (4%) 2.80 <br /> <br />I agree to build according to the submitted plans and specifications, the lawt¢ of the <br />State of Oregon and the Ordinances of Marion County,, PERMIT EXPIRES IF WORK <br />NOT COMMENCED WITHIN tSO DA YS. / further expreaaly warrant that I comply with <br />the prowsiona of ORS 701,005 to ?OL 125 because: <br /> <br />( ) t am perform)'ng work on a property I own <br /> or OcCupy <br />( ) I an a registered builder OR ( ) the <br /> autho[ized representaHve of a <br /> regiatered builder <br /> <br />( ) The work will be performed <br /> by a registered builder <br />( ) Other (please specify) <br /> <br />Plane Chk. Fee; <br />Septic Tank <br />Permit Fee,: .~ 60.00 <br /> <br />DEQ Surcharge" 5.00 __ <br /> <br />TOTAL FEE:: <br />6LOG <br />RECEIPT NO.: <br />Drweway <br />Permit Fee. <br />Site Plan <br />Review Fee, <br />Public Works <br />Receipt NO ' <br /> <br />140~30 <br /> <br />REMARKS__ <br /> <br />S~GNATURE OF APPLICANT:: '~ ~ ~-,~--..J~ _ <br /> PLEASE NOTE; Orivew~nd sidewalk inspection are required by Public Works 588-5036 <br /> Other permits required by this dept,: Plumbing E~ E~ectrical n Mechanical [] <br /> <br /> <br />