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~IB~T.~ ~1~ BUILDING INSPECTION I ~,,,~enator Building #225 <br /> ~Qr~, ~HighSt,NE 2nd Floor Permit No <br />Appl ,Recd Miry 0 ~/~0! salem, Oregon 97301 <br /> <br /> .... MARION. COUNTY 588-5147 -- 58S-514S <br />Date ~,5--oc/? BUILDIN~ ~]S~'~CTt0N ........ CODE-A-Phone ...................... 8::00 A.M, Date <br /> <br />Bldr & No , Phone <br /> <br />......... Address:: <br /> <br />Plans by _Phone Address:: <br /> Map Page ~ono Zone Change Cond Use Variance/Adj FT/FD Occupancy Type~of on ' <br /> ....... ,~- / ~-~ <br /> <br />LotNo,--/~// Blk No, /3 __Sub,,dv,; ff4:~}91'094~/O/ LotSize'/O6iS/~5_Corner? <br />Area of Bldg 2nd Base- Total ~Y¢ <br />Main FI r, Fir,,;: ~ent' Area, ]~ ~ ~ Valuation' <br /> ~ldg, Permit <br />Roof Type:: Truss/Stick:: Height:: ~ Fee: (* <br />Heating Wood Water <br />System:: ,. Stove:: Supply:: Elect, Fee:: <br />Septic Tank New <br />Site E~al Instal,:: Mech, Fee <br />Exist No <br />System:: Gals,:: Plumb, Fee <br /> State <br /> Surcharge:: <br /> <br />VALIDATIONS <br />Zoning:: <br />Date, <br />Septic Tank' <br />Date <br /> <br /> Mechanical:: <br /> Oate:: <br /> Plans ~' <br /> _Date: ,,~)/J~ - ~'~ <br /> <br />I agree to build according to the 8ubmitted plans and specihcat~ona, the laws of the <br />State of Oregon and the Ordincmces of Marion County PERMIT EXPIRES IF WORK <br />NO T COMMENCED WI THIN 180 DA YS, I further expreasly warrant that I comply with <br />the proweions of ORS 701,005 to 701,125 because: <br /> <br />(?~,) I am performing work on a property I own <br /> or occupy <br />( ) t am a registered builder OR ( ) the <br /> authorized representative of a <br /> registered builder <br /> <br />) The work w/Il be performed <br /> by a registered buttder <br />) Other (please specify) <br /> <br />Plans Chk,, Fee:: <br /> <br />TOTAL FEE:: <br />BLDG, <br />RECEIPT NO <br />Driveway <br />Permit Fee <br />Site Plan <br />Rewew Fee: <br />Public Works <br />Receipt No:: <br /> <br />REMARKS <br /> <br />I have read this apphcation in its entirety and certify that the stated information is true and correct to the best of my Rnowledge <br /> <br />S' "AT EO APP ,CA.T . <br /> PLEASE NOTE:: Dri;eway and side~va~ insp'~ection are req.ir%d by Public Works %'8'8-5036 ~ <br />MC ~5-6 ' ' · B · <br /> <br />~v 7- 85 Other permits required by th~s dept Plumbing Electrical B Mechamcal ~ <br /> <br /> <br />