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COO <br /> 41��.y4z. Agricultural or Forestry Building Exemption Certification ✓ O /] <br /> Equine Facility Exemption Certification U V <br /> Marion County Public Works-Building Inspection Division - <br /> Nation 5155 Silverton Rd.NE, Salem Oregon 97305 JUL O/2022 <br /> Phone: (503) 588-5147 Fax: (503) 588-7948 Email: building@co.mari niorr U N , <br /> OREGON BUILDING INSPECTION <br /> ((Site Plan is Required-see attached information <br /> Owner/applicant name: (yt.A c,`�""� Phone: G3 5� Z`� Email: 0J4 1‘'"` <br /> Mailing address: � 2 3 Q� +�w. ft. Se City/State: `2-,-- Zip: Ct <br /> Job site address: 5��-'---r�_ City/State: Zip: <br /> Parcel Information: Parcel Size: (1)V Pr Parcel No.: Zone: <br /> 0g2w170 o0400 <br /> Proposed Building Information I <br /> Describe specific use of the building and items contained within �ot., �`1' sr 0 <br /> I i D — I <br /> Building Data: Length: Z y Width: Area: t Height: <br /> Type of Exemption:agricultural Building o Forestry Building o Equine Facility(Provide information below): <br /> What is the proposed maximum number of people(including employees, owners, etc.)that will be present in the building at <br /> any one time? , <br /> Will this structure be used by the public at any time? oYes ` To <br /> Is the proposed structure located within a floodplain? oYes YNo <br /> Is the building located on/used in the operation of a farm?1Yes o No <br /> Is the proposed structure a residential dwelling or manufactured home? oYes To <br /> Is the use of the structure or the items within it used for any business or commercial activities? oYes Vo <br /> If yes,please explain: <br /> Agricultural/Equine Exemption Criteria-Select all that apply: <br /> ?cS maintenance, or repair of machinery, equipment, and supplies used on this farm <br /> o Raising,harvesting, or selling crops raised on this farm <br /> o Feeding,breeding,management, or sale of livestock, poultry,furbearing animals,or honeybees <br /> o Dairying or the sale of dairy products produced on this farm <br /> o Other agricultural,horticultural, or animal husbandry used <br /> o Stabling,training,riding lessons, or clinics(Complete Equine Exemption Criteria) <br /> #of stalls/horses <br /> #of stalls/horses for personal use only <br /> #of stalls/horses used for commercial or trade purposes including boarding,training,rentals,clinics, shows,etc. <br /> Which of the following systems will the proposed structure have? <br /> Electrical oYes eX.No(Complete Electrical Wiring Criteria) <br /> Will there be a concrete slab either within or adjacent to the building? oYes KNo <br /> Will there be farm animals(poultry excluded)within the building at any time? oYes XNo <br /> Will there be farm animals(poultry excluded)on the slab at any time? oYes ?(No <br /> Will the building be used for storage of feed,hay, or straw?1Yes o No <br /> Will the building be used for major repair of motor vehicle equipment? oYes XL No <br /> Heating/cooling/ventilation/mechanical oYes ENo <br /> Septic oYes o (Any yes answer will require a separate permit) <br /> Plumbing(Please specify fixture type) oYes <br /> No <br /> Page 1 of 5 <br />