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Marion County Building Inspection <br />555 Court St. N.E., Room 2260, PO Box 14500 Salem, Oregon 97309-5036 <br />Office Hours: 8:00-4:30 Phone: (503)588-5147 Inspection Line: (503)373-4427 <br /> <br />BUILDING PERMIT <br /> <br />DATE: 01-22-2004 TYPE: BUILD ACTIVITY NO: <br />OFFICE: MC USE: STATUS: <br />CONST: V-N MAP: ISSUED: <br />UGB: ZONE: ID TO EXPIRE: <br />OCC: ?? SITE: <br /> <br />98-00676 <br />EXPIRED <br />03/17/1998 <br />09/13/1998 <br /> <br />WORK DESC: <br /> <br />SITS ADDRESS: <br />PARCEL: <br /> <br />APPLICANT: <br /> ADDRESS: <br /> <br /> PHONS: <br /> <br />OWNER: <br /> ADDRESS: <br /> <br /> PEONS: <br /> OCCUPANT: <br /> <br />CONTRACTOR: <br /> ADDRE88: <br /> <br /> PHONS: <br />TOTAL SQ FT: <br />VALUATION: <br /> <br />TRUCK DIRECTIONAL SIGN #1 <br /> <br />21856 NE BSNTS RD AR <br />041W09 01100 <br /> <br />CW TOWER INDUSTRIES LTD <br />PO BOX 23910 <br />PORTLAND, OR 97281 <br />620-8228 <br /> <br />NATIONAL AUTO TRUCKSTOPS <br />PO BOX 76 <br />NASHVILLE, TN 37202 <br />N/A <br /> <br />CW TOWER INDUSTRIES LTD <br />PO BOX 23910 <br />PORTLAND, OR 97281 <br />620-8228 <br /> <br />OCCB~: 0064325 <br /> <br /> 0 1ST FLOOR: 0 <br /> 2ND FLOOR: 0 <br />$2,000.00 3RD FLOOR: 0 <br /> <br />GARAGE: 0 HEIGHT: 20 <br />BASEMENT: 0 STORIES: 1 <br />OTHER: 0 <br /> <br />Units <br /> <br />77 <br /> <br />Description <br />Building Fee <br />Investigation Fee <br />Footing/Foundation <br />Change/Occupancy <br />Building Plan Review <br />Fire Life Safety <br />Additional Sets of Plans <br />Additional Plan Review <br />Addendum Hours Fee <br />Special Plan Review <br />Plan Review Handling Fee <br />Other Fee <br />Misc/Copy Fee <br />Reinspection Fee <br />Overtime Inspection hfs <br />Other Inspection hours <br /> <br /> Fee Units Description Fe__e <br />$32.50 SDC's for ?? <br />$0.00 SDC Urban Growth ?? <br />?? SDC Rural ?? <br />$0.00 SDC Parks ?? <br />$21.13 Driveway Fee ?? <br /> $0.00 Site Plan Review $0.00 <br /> $0.00 State Surcharge $2.28 <br /> $0.00 zoning Surcharge $6.50 <br /> ?? Seis~c Surcharge $0.00 <br /> $0.00 ?? Hrs Addtnl Support Staff ?? <br /> $0.00 Refund $0.00 <br /> ?? <br /> ?? Total Assessed Fees: $62.41 <br /> $0.00 Adjustments: $0.00 <br /> $0.00 Total Fees: $62.41 <br /> $0.00 Total Pa~ents: $56.89 <br /> Balance Due: $5.52 <br /> <br />THIS PERMIT EXPIRES 180 DAYS FROM THE ISSUED DATE IF WORK HAS NOT COP~ENCSD, OR IF CONSTRUCTION CEASES FOR A <br />PERIOD OF 180 DAYS, OR IF WORK FAILS TO MEET ALL REQUIREMENTS OF STATE LAWS AND MARION COUNTY ORDINANCES. UPON <br />WRITTEN REQUEST, PRIOR TO EXPIRATION, ONE SIX MONTH EXTENSION MAY BE GRANTED. <br /> <br />[ ] I am the PROPERTY OWNER and own, reside in, or will reside in the completed structure and will be my own <br />general contractor. I understand that I must register as a construction contractor if the structure is sold or <br />offered for sale before or upon completion. If I hire subcontractors, I will hire only sub-contractors <br />registered with the Construction Contractors Board. If I change my mind and do hire a general contractor who is <br />registered, I will immediately notify Marion County of the name of the contractor. <br />[ ] I am the CONTRACTOR registered with the State of Oregon. <br />[ ] I am an AUTHORIZED REPRESENTATIVE of the property owner or contractor. <br /> <br />SIGNATURE OF APPLICANT: X <br /> <br /> <br />