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001735-AG c- Agricultural or Forestry Building Exemption Certificatlnn 177 quine Facility Exemption Certification D E L I U I Q Lop 'as unty Public Works-Building Inspection Divisio [Marion y J55 Silverton Rd. NE, Salem Oregon 97305 _ uA Phone: (503) 588-5147 Fax: (503) 588-7948 Email: building@co.marion.o�+.4SR J 7 019 OREGON MARION COUNTY UILDING INSPECTION Owner/applicant name: R U n 41 A I I 5 f rn pork Phone: 7 l — $`7-36 764,.ax: Mailing address: i C i.) 5 Li min i f L-o 5 e City/State: TU rn ( rcrZip: ifig4A4 3 9:4 Job site address: /31 '`j .9 0 VC y `, yi S F City: r r)c v Zip: q 7 3 9,2. Directions to the site: • , r I i v • - - L-a 5 + v !S c C r Proposed Building Information '� , 1. Site plan is attached(required): cAYes o No 2. Type of Exemption: 'Agricultural Building o Forestry Building o Equine Facility(provide information below): o Total number of stalls or equivalent number of horses: o Total number of stalls or equivalent number of horses limited to personal use only: o Total number of stalls or equivalent number of horses anticipated to be used for commercial or trade purposes inc. boarding,training,rental, haul-in, clinics, shows, etc. (consider future plans): 3. Is the use of the structure or the items within it used for any business or commercial activities? ales )1kNo If yes, please explain: 'WO 4. Describe use of the building and items contained within: ram QQLI y'r{` > p Gt reel__ 5. Is the property in farm or forest deferral? oYes kNo 6. Is the proposed structure located within a floodplain? oYes plc) 7. Will the proposed structure have any of the following systems? (If yes, separate permits are required for each system): Plumbing oYes )(No If plumbing will be installed,what type of fixture(s)? Electrical ❑YesNo Septic oYes 'To Heating/Cooling/Ventilation/Mechanical oYes No 8. Will this structure be used by the public at any time? oYes )(No 9. What is the proposed maximum number of people(including employees, owners, etc.)that will be present in the building at any one time? _ 10. Where will restroom facilities be provided? NONE lt)(04) t .&i dJ(s) 11. Is the proposed structure a manufactured home? oYes to 0ILI 12. BuildingData: Length: fi<i� ' '� $Area: q � �� Width: ";�/� � 1 � � � p Height: 13. Parcel Information: Parcel Size: I\ •5 OC.KSParcel No.: RZone: ruwn 55- i 7re)q ) 6c; Page 1 of 5