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Agricultural or Forestry Building Exemption Certification /D I C C 11 <br /> En <br /> Equine Facility Exemption Certification V <br /> Marion County Public Works—Building Inspection Division <br /> Marion 5155 Silverton Rd.NE, Salem Oregon 97305 MAR 7 2019 <br /> county Phone: (503)588-5147 Fax: (503) 588-7948 Email:building@co.marion.dkU , =i►0 <br /> OREGON <br /> ILD,NG I/ sp NTI7N <br /> Owner/applicant name: Lc._Zcs- kyfsev Phone: r03 78 t cl4(4.i Fax: <br /> Mailing address: 3Z 73 7 “i d wy S 1— City/State: Woe lb v i•h a Zip: 7d 71 <br /> Job site address: l y S S Goudy l�G.rde:,5 L Al NE City: W vc ctb (,l.rn 0 k Zip: '110`71 <br /> Directions to the site: <br /> Proposed Building Information <br /> 1. Site plan is attached(required): KYes ❑No <br /> 2. Type of Exemption: NAgricultural Building o Forestry Building ❑Equine Facility(provide information below): <br /> o Total number of stalls or equivalent number of horses: <br /> o Total number of stalls or equivalent number of horses limited to personal use only: <br /> o Total number of stalls or equivalent number of horses anticipated to be used for commercial or trade purposes <br /> inc. boarding,training,rental,haul-in,clinics,shows,etc. (consider future plans): <br /> 3. Is the use of the structuretor the items within it used for any business or commercial activities?1 Yes ❑No <br /> If yes,please explain: 6f't .C, �J�{ <br /> 4. Describe use of the building and items contained within: cCr Acfy 0 ci N cora t`c.5Ifcv"1 <br /> 5. Is the property in farm or forest deferral? ❑Yes ❑No <br /> 6. Is the proposed structure located within a floodplain? oYes ❑No <br /> 7. Will the proposed structure have any of the following systems?(If yes,separate permits are required for each system): <br /> Plumbing .cYes o N 5 If plumbing will be installed,what type of fixture(s)? <br /> Electrical EkYes o No �Je fM'_L (e Ot(sec( f( `S <br /> Septic slYes o No (-L. <br /> Heating/Cooling/Ventilation/Mechanical racYes ❑N <br /> 8. Will this structure be used by the public at any time? ❑Yes cQ No <br /> 9. What is the proposed maximum,, ,mber of people(including employees,owners,etc.)that will be present in the <br /> building at any one time? 9 <br /> 10. Where will restroom facilities be provided? <br /> 11. Is the proposed structure a manufactured home? ❑Yes ig)No <br /> 12. Building Data: Length: ' 1 Width: LA U k t Area: 1-10 T Height: <br /> 13. Parcel Information:Parcel Size: 1 q 7 Parcel No.: Zone: V <br /> Page 1 of 5 <br />