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AppL
<br />
<br /> Pattie
<br />
<br />Date: t}~ 3/28/84
<br />
<br /> MARION COUNTY
<br />OEPT, OF BUILDING INSPECTION
<br />Senator Building # 225
<br />220 High St., N,E. 2nd Floor
<br /> Salem, Oregon 97301
<br />
<br /> 588-5147 - 588-5148
<br />5:00 P.M..- ...........CODE-A-Phone 588-5373 ........... 8.00
<br />
<br />Type of Permit:
<br />
<br /> Permit No. ~ r
<br /> By: ~._ 84~471
<br /> , Doffio,
<br />
<br /> Date: . _ ,
<br />· ~4/5/$4
<br />
<br />Address:
<br />
<br /> Adding bedroom & storage area to mobLle homeFax Lot No: ~0866"000
<br />
<br /> Address: 12123 Fry Roadt N1[ Aurora Sec. 21
<br /> . Twnshp. ~Rge.
<br />
<br />Owner:: Ronald A, Jee Phone: 678'15,/~6' Add,ess: ea~e ,w;Lll pick up
<br />
<br /> Call work 378-6551
<br />mldr, & No.:: same , , Phone: _
<br />
<br />Plans by; Phone: Address:
<br /> ~ep p,we EF~ Zone Ch,,
<br /> 6 , , , I Var~n~ tFtreZ°n'
<br /> addn to ~bile home 3 , ,
<br /> total
<br />
<br />Lot No,= .... BIk. Moa__ _Sub dy. ,,
<br />Area of Bldg- 2nd Base- Total
<br />Main Fir,:__. Fir.=, menh Area: 288 ,?q
<br />
<br />. OccuPancy " Type of Con,t,
<br />
<br />Lot Size 4 · 5,,Ac re~orner?__ no
<br />
<br /> Valuation:_
<br /> Bldg. Permit
<br />Roof Typm met. a[ Truss/Stick: .st;Lc, k, Fee: ( + 5%)
<br />Heating Wood Water
<br />System:__ Stave:~ Supply:_ Elect. Fee: ,
<br />Septic Tank New
<br />Site Evah , Instal · Mech, Fee:~ ,.
<br />Exist,, No.
<br />System , ,~ , Gals.! Plumb. Fee=
<br /> State
<br /> Surcharge:~
<br />
<br />VALIDATIONS: ~
<br />
<br />Mechanicah
<br />
<br />I agree to build according to the submitted plans and specificotmns, the lows of the Sta~
<br />of Oregon and the Ordinances of Marion Count/, Permit expires if work not commenced
<br />w~thin 180 days. I further expressly warrant that I comply with the provisions of ORS
<br />70 L005 to ?O L 1~$ because~
<br />( ) I am performing work on a property I own or occupy
<br /> ) I am a registered builder OR ( ) the authorized
<br /> representative of o registered builder
<br />
<br />, 5~328,00 ~_
<br /> 56.50
<br />
<br />2.26 ~'
<br />
<br />Plans Chk. Fee: 36. ?~
<br />Septic Tank 60..00
<br />Permit Fee=_
<br />
<br />DEQ Surcharge:~
<br />
<br />5,00
<br />
<br />TOTAL FEE: /63 °32
<br />
<br />The work will be performed by a registered builder
<br />Other (please specify)
<br />
<br />REMARKS::.
<br />
<br />PLIEASE NOTE: Driveway and sidewalk inspecti~ns are required by Publi¢ Works: ~ ~88-5036
<br />Other permits required by this dept: Plumbing [~] Electrical
<br />
<br />
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