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.X 6 ` : / .."0 - O' 2 d3-S'545-DEPT. OF BUIOLDINO INSPECTION <br /> d`- 7- I C. ' <br /> Downtown Senator Building <br /> Appl. Revd: 220 High St., N.E. 2nd Floor Permit No. <br /> Salem,Oregon 97301 <br /> By: R.H.WITHROW,BLDG.ADMINISTRATOR By: <br /> 588-5147 — 588-5148 <br /> `late: Date: 11 <br /> Type of Permit: Tax Lot NC J <br /> Address: Sec. Twnshp. / Rge. • • • <br /> Owner: - <br /> - Phone: - Address. <br /> Bldr.& No.: - Phone: Address: <br /> Plans by: - Phone: Address: <br /> ' Map Page Zone Zone Chg. Part. Cond.Use Variance Fire Zone Occupancy Type of Const. <br /> e l Min Req. Front Sides Rear <br /> Use of Bldg.: Setbacks: <br /> Lot Not Blk. No: Sub dv. Lot Size 7• --- Corner? <br /> . _ <br /> Water Supply: - Valuation: S r <br /> Sewage <br /> Disposal: -- Study: Permit Fee: <br /> No. <br /> Area of Bldg: - Stories: --- State Surcharge: - — <br /> Roof <br /> Basement: Type: - Plans Chk. Fee: <br /> `leating <br /> bystem: Septic Permit Fee: <br /> BTU: Total Fees: <br /> Rcpt. No: <br /> I agree to build according to the submitted plans and specifications, the laws of the State of Oregon and the Ordinances of Marion <br /> County. Permit expires if work not commenced within 120 days. <br /> SIGNATURE OF APPLICANT: <br /> VALIDATIONS: PLANS <br /> ZONING SEPTIC TANK <br /> By. By: By: <br /> Date: Date: , Date: - <br /> • REMARKS <br /> • <br /> ILK <br /> PLEASE NOTE: Driveway and sidewalk inspections are required by Public Works: 588-5036 <br /> Other permits required by this dept: Plumbing ❑ Electrical ❑ <br />