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Appl Recd <br /> <br /> 7 <br /> <br /> MARION COUNTY <br /> DEPT. OF BUILDING INSPECTION <br /> Senator BuiYding #225 <br /> 220 High St, NE 2nd Floor Permit NO <br /> Salem, Oregon 97301 <br /> 5B8~5147 -- 588-5148 By:: <br /> <br />5:00 PM CODE-A-Phone 8:;00 A..M.. <br /> Date:: <br /> <br />Owner:: Co o I Pho.e::,,, ^ddrees;: <br /> <br />Bldr & No, <br /> <br />Use of Bfdg <br /> <br />.Phone:: Address <br /> <br />Lot NO :;__ ~, ~ BIk NO, <br />Area of Bids 2nd Sase- Total <br />Main Fir, .Fir :: merit: Area:: <br /> <br />Roof Type'..~' /~/,~/~. ~- Truss/Stick: <br /> <br />Heating Wood Water <br />System:: .Stove:: ...... Supply:: <br />Septic Tank New <br />Site Eval,," Instal :: <br />Exist No, <br />System:: ...... Gals, <br /> <br />VALIDATIONS:: <br />Zoning:: Mechanical: <br />Date:: ___Date <br />Sepbc Tank Plans:: <br />Date _Date <br /> <br />Valuation;: <br />Bids. Permit <br />Fee:: (.* 5%) . <br /> <br />Elect Fee:: <br />Mech Fee:: <br /> <br />Plumb Fee: <br />State <br />Surcharge;: (4%) <br /> <br />I agree to build according to the submitted plans and specifications, the laws of the <br />State of Oregon and the Ordinances of MariOn County. PERMIT EXPIRES IF WORK <br />NO T COMMENCED WITHIN 180 DA YS. I further expressly warrant that I comply with <br />the provisions of ORS 701.005 to 701. 125 because: <br /> <br />( ) I am performing work on a property I own <br /> Or occupy <br />( ) I am a registered builder OR ( ) the <br /> authorized representative of a <br /> registered builder <br /> <br /> ) The work will be performed <br /> by a registered builder <br />( ~) Other (pie, ass specify) ~ <br /> <br /> Corner?. <br /> <br />,,, i l <br /> <br />Plans Chk Fee:: <br /> <br />TOTAL FEE:: <br />BLDG <br />RECEIPT NO,:: <br />Driveway <br />Permit Fee,_ <br />Site Plan <br />Review Fee::, <br />Public Works <br />Receipt NO <br /> <br />REMARKS <br /> <br />I have read this application in ita entirety and certify that the stated information is true and correct to the best of my Rnowiedge. <br /> <br />SIGNATURE OF APPLICANT:: ~.,,'~.~-____.~ ' <br /> PLEASE NOTE. Driveway and sidewalk inspection are required by Public Works:: 58845036 <br /> <br /> <br />