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Co7oz- <br /> •� Y4'�ye Agricultural or Forestry Building Exemption Certificatio i �— <br /> . Equine Facility Exemption Certification J L LED <br /> [I <br /> Marion County Public Works—Building Inspection Divi ' <br /> Maournn 55 Silverton Rd.NE, Salem Oregon 97305 j AUG 28 2 c 4 <br /> Phone: (50 �,147 Fax: (503) 588-7948 Email: building(,co.marion.or.us <br /> IvI�,l dION COUNTY <br /> 0 REGON BUILDING INSPECTION <br /> t%Plan is Required—see attached information <br /> Owner/applicant name: \ £ c{t Phone: S-03 `�7O��Z,� Email: -5.),)- t L hh bt <br /> Mailing address: �l/ Po(O¢� r et• City/State: %?-►c,, niV �e l t Zip: �7 1 z..-- /7/®Job site address: year ()Ai g en.( 41 c City/State: MI:Ave( C,Qc Zip: 3 73.6z <br /> Parcel Information: Parcel Size: Parcel No.: Zone: <br /> Proposed Building Information <br /> Describe specific use of the building and items contained within tr.ia- et,4 j y '�ct'yt <br /> OGltu ilevK.vic o k e __ / <br /> Building Data:Length: oo FF,,(. _ Width: S6 F d- Area: OW -,,F P Height: 32 �� <br /> Type of Exemption: yl Agricultural Building o Forestry Building ❑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 No <br /> Is the proposed structure located within a floodplain? oYes jNo <br /> Is the building located on/used in the operation of a farm? 7Yes ❑No <br /> Is the proposed structure a residential dwelling or manufactured home? oYes /it(No <br /> Is the use of the structure or the items within it used for any business or commercial activities? oYes tNo <br /> If yes,please explain: <br /> Agricultural/Equine Exemption Criteria—Select all that apply: <br /> X Storage,maintenance, or repair of machinery, equipment, and supplies used on this farm <br /> 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 Yes o No(Complete Electrical Wiring Criteria) <br /> Will there be a concrete slab either within oo,a,cljacent tothe building? Yes ❑No <br /> Will there be farm animals(poultry excluded)withiti the'building at any time? oYes ye No <br /> Will there be farm animals(poulti excluded)on the slab at any time? oYes XNo - <br /> Will the building be used for storage of feed,hay, or straw? bYes '`,&j No <br /> Will the building be used for major repair of motor vehicle equipment? oYes XNo <br /> Heating/cooling/ventilation/mechanical oYes g�No <br /> Septic oYes No (Any yes answer will require a separate permit) <br /> Plumbing(Please specify fixture type) oYes ANo <br /> Page 1 of 5 <br />