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�— o I-' 1 '1 d- 2)-id3-5. 4- b °MARION COUNTY a' 7-. iE. <br /> DEPT. OF BUILDING INSPECTION <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 /> Date: <br /> .gate: 1 <br /> Type of Permit: Tax Lot Nc J <br /> Address: Sec. Twnshp. Rge. <br /> Owner: 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 /> Use of Bldg.: Min Req. Front Sides Rear <br /> Setbacks: <br /> Lot No. Blk. No: Sub dv. Lot Size Corner? <br /> Water Supply: Valuation: S <br /> Sewage Feas. <br /> Disposal: Study: Permit Fee: <br /> No. <br /> Area of Bldg: Stories: State Surcharge: <br /> Roof <br /> Basement: Type: Plans Chk. Fee: <br /> _,,!eating <br /> System: Septic Permit Fee: <br /> BTU: Total Fees: <br /> Rcpt. No: <br /> l agree to build according to the submitted plans and specifications, the laws of the Stare of Oregon and the Ordinances of Marion <br /> County. Permit expires if work not commenced within 120 days. <br /> SIGNATUI-IE OF APPLICANT: <br /> VALIDATIONS: <br /> ZONING SEPTIC TANK PLANS <br /> By: By: <br /> By: <br /> Date: <br /> Date: Date: <br /> • REMARKS <br /> s. <br /> vir <br /> PLEASE NOTE: Driveway and sidewalk inspections are required by Public Works: 588-5036 <br /> Other permits required by this dept: Plumbing ❑ Electrical Li <br />