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3150 LANCASTER DR NE - SUITE C <br />__ SAEEM OREGON 97305 503-588-5147 <br /> <br /> APPLICATION FOR EXEMPT STATUS FROM THE STRUCTURAL SPECIALITY CODE <br /> EaR AN AGRICULTURAL BUILDING ON A COMMERCIAL FARM <br />PROPOSED LOCATION: I~1_~~ ~l~L~ ~"~k.J ~ ~.~'-'J~VI ~J~_.:O~ <br /> I <br /> <br />BUILDING SIT~ ACRES: [; ~ <br /> <br />1. Is this property classified by the Assessor as farm deferred? <br /> <br /> TAX ACCOUNT: <br /> <br />TOTAL//OF ACRES FARMED: <br /> Yv/'N <br /> <br /> Y iN <br /> <br /> 2. Are you located within the Urban Growth Boundary? <br /> <br /> (~BE 5PECIEIC in describing your commercial farm enterprise, Size of. operation, and annual profit. If applicable, <br /> provide proof of farm income for the last three (3) years. <br /> <br />~ E SPECIFIC in Describing the use of and/or commodities that will be stored in the proposed structure: <br /> <br /> 5. What is the size of the proposed building? LENGTH q~ WIDTH~ HEIGHTt~ ~REA <br /> <br /> 6. Is the proposed structure located within a flood plain? Y N <br /> <br /> 7. Will the propped structure have any of the following systems? If yes- separate permits are required. <br /> Electrical Ye N Plumbing Y N ~ HeatinffCoolin~entilation Y N <br /> <br /> 8. Where will restroom facihfies be provided? ~,4g~ <br /> <br /> 9. What is the maximum number of people present in the building at any one time during the year? <br /> <br /> 10. Is this structure used by the public ~t any time? Y <br /> Explain <br /> <br />1 1. What is the distance from the proposed structure to property lines and/or other structures? Front I.L.,~ Rear ~(.,~ Left side__ Right side Other <br /> <br />12. This application will not be considered complete without a'site plan that includes the size of the building. <br /> **See attached site plan requirements. <br /> <br />DATE <br /> <br />I certify that I have read this application and state that the information given is correct."l agree to comply with <br />all state laws and county ordin_ances relating to building construction. <br /> <br /> NAME (Ple~ase Print) <br /> <br /> STREET ADDRESS <br /> <br />PHONE <br /> MC15-76-REV 7/97 <br /> APPROVED <br /> <br /> CITY <br />FOR OFFICE USE ONLY <br />DENIED <br /> <br />STATE/ZIP CODE <br /> <br />DATE <br /> <br /> <br />