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V3k_-0o2277— AGE <br /> Agricultural or Forestry Building Exemption Ce - <br /> E. 'ie �,,_� ;�` �� •tion Certification <br /> M 'o .r..^j�'it� `°�` �i� Building Inspection i ion <br /> 1�arion - ��4���• , ���• Salem Oregon 973G5 <br /> county Phone: 503 `; 5�� '�.. , a ?I ] s 2 i <br /> ( • (503) 588-7948 Email:buildin�a,co.m r. <br /> OREGON MARION COUNTY <br /> ,BUILDING INSPECTION <br /> Owner/applicant name: ( t) cL .L jr �`re-? Phone: 5)3 $ 5t5�1 r <br /> Mailing address:j9 6, 7,5 ( .1 C�,ice. �-r,r, Q,,i City/State: Zip: ? 3 Z S <br /> Job site address: 6. 7-'2, L.) City: IL yn.c-1-1.'(( z Zip: 2_5 <br /> Directions to the site: <br /> Proposed Building Information <br /> 1. Site plan is attached(required): oYes o No <br /> 2. Type of Exemption:-agricultural Building o Forestry Building o Equine Facility(provide information below): <br /> o Total number f 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 structure or the items within it used for any business or commercial activities? oYes o No <br /> • If yes,please explain: <br /> 4. Describe use of the building and items contained within: S icnrlt� e > n -r <br /> $�V:jl�x-Cid ou.„" itt r <br /> 5. Is the property in farm or forest deferral? pitYes o No <br /> 6. Is the proposed structure located within a floodplain? cilres No <br /> 7. Will the proposed structure have any of the following systems?(If yes,separate permits are required for each system): <br /> Plumbing ) Yes ❑N If lumbing will be installed,what type of f ture(s)? <br /> -1 7kt ose I;,ys <br /> Electrical Yes ❑ "4;i�� /Qj; , <br /> Septic 'es Xl&o <br /> Heating/Cooling/Ventilation/Mechanical oYes ),'No <br /> 8. Will this structure be used by the public at any time? oYes &No - <br /> 9. What is the proposed maximum number of people(including employees,owners, etc.)that will be present in the <br /> building at any one time? <br /> 10. Where will restroom facilities be.provided? • <br /> 11. Is the proposed structure a manufactured home? oYes _ 5tNo <br /> 12. Building Data:Length: - Width: 40 .41- Area: Height: <br /> pp�� <br /> 13. Parcel Information:Parcel Sizes° Parcel No.: Zone: <br /> Page 1 of 5 <br />