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5o <br /> <br /> MARION COUNTY <br /> BUILDING INSPECTION <br />Community Development Center · 285 Church St. NE · Room 132 · Salem, Oregon 97301 <br />Office Hours: 8:00 - 4:30 Phon~. 588-5147 24 Hour Cod~A-Phone: 58~7904 <br /> <br /> APPLICATION FOR EXEMPT STATUS <br /> FROM THE STRUCTURAL SPECIALTY CODE <br /> FOR AN AORICULTURAL BUILDINO ON A CO~RCIAL <br /> <br />Is this property classified as farm deferred? Y /~ N __ <br />(You must provide a computer printout verifying special assessment for farm use. <br />This can be obtained at the Marion County Assessor's Office located in the Franklin <br />Building, 495 State Street, Salem) <br /> <br />Are you located within the Urban Growth Boundary? Y __ N <br />D~scribe in detail your qo~ercial ~arm en~er~rise~ ~~ <br /> <br />Describe in debail the use of and/or co~odities stored iW the proposed structure: <br /> <br />is th~ <br /> proposed structure located within a flood plain? Y __ N <br /> <br />Does the proposed structure have any of the. following systems? <br />Electrical Y ~)( N Plumbing Y ~ N ~ Heating/Cooling/Ventilation Y~ N~ <br />Where will restroom facilities be provided? ~x~ ~ ~~--~/A~-J ~6Or~_. <br /> <br />Will persons be working in the structure more than a total of 144 h~urs, during any <br />week of the year? Y N ~._ <br />Is this structure used by the public at any time? Y__ N~ <br />~xplain: <br /> <br />10. <br /> <br />What is the distance from the proposed structure to property lines and/or other <br />structures? Front ~ Rear /d d <br /> Left Side /~ Right Side /D~ Other structures <br /> <br />11. <br /> <br />This application will not be considered complete without a site plan. See attached <br />site plan requirements. <br /> <br />Z certify that I have read this application and state that the information given is <br />correct.. I/a~_~e to comply with all state laws and county ordinances relating to building <br />constru~ <br /> SI~ATURE NAME (APl~a~e print) <br /> <br /> DATE ' STREET ADDRESS ' <br /> <br /> PHONE CITY STATE ZIP <br /> <br />OFFICE USE ONLY <br />PLANNING DIVISION: <br /> Validated By:__ <br /> <br />COMMENTS: <br /> <br />SITUS NO. ZONE: MAP: <br /> Approved: Denied: Date: <br /> <br /> Validated By: ~ Approved: Denied: Date: <br /> <br /> Okher per,ks requ~red:~ P~-m~ng, Nechan~ca~, Sepk~c <br />MC 15-76 <br />~V 8/~4 <br /> <br /> <br />