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?' MARION COUNTY <br /> DEPT. OF BUILDING INSPECTION <br />AppI. Read: 220 High St., N.E. 2nd Floor Permit No. <br /> Salem, Oregon 97301 <br />Dy; Dottle By: ~ <br /> 588-5147 - 588-5148 <br />Date: 3/7/8~ 5:00 P.M ............. CODE-A-Phone 588-5373 ........... 8:00 A.M. Date: ~;~ --//'~-~'~ <br /> / <br /> existin~ roof <br /> ~o finishin~ utility room under Tax Lotto: <br /> <br /> 8723 Sha~ Sc~are Road~ Nm` Aumsville Sec. ,,Twnshp._ <br /> <br />Type of Permit: <br />Address; .Rge <br />Owner: Phone:/~ <br />Bldr. & No.: <br /> .... ~'~'~~~ ~__/~,~f~ ~c~..~c~..~._' 97301 <br />Ptans by; <br />Map Page ,~one Zol3e Chg. Part., Cond. Use' Variance I FireZone Occupancv[ Type of Caner- <br /> <br />Lot No.. __BIk. No.- Sub dv. , Lot Size ..... Corner? .... <br /> <br />Area of Bldg. 2nd Base- Total 4~ 100, <br />Main Fir.: Fir,;- ment:__ Area: Valuation: .... 4~o45 <br /> Bldg. Permit <br /> 2°32 <br />Roof Type~ __Truss/Stick:-, Fee~ ( + <br /> <br />Heating <br />$ystem: <br />Septic Tank <br />Site I~vah <br />Exist. <br />System:_ <br /> <br />Wood Water <br />Stove: __ Supply: Elect. Fee:- Apple <br /> <br /> New <br /> __ Instal.:. <br /> No. <br /> _ Gals.: ,~ Plumb. Fee: <br /> State <br />VALIDATIONS: Surcharge: <br />Zonlng: Mechanical: <br />Dote: Date- Plans Chk. Fee: <br />Septic Tank: Plans: Septic Tank <br />Date Date: /~("J ~ "; !~' -"~ %'! Permit Fee;. <br /> <br />Mech. Fee:. <br /> <br />JudsonSs <br /> <br />1.86 <br /> <br />I agree to build according to the submitted plans and specifications, the laws of the State DEQ Surcharge:,~ <br /> <br />of Oregon and the Ordinances of Marion County~ Permit expires if work not commenced <br />within 180 days. I further expressly warrant that I comply with the provisions of ORS TOTAL FEE: ..... $0°82 <br />701.005 t? 701. 125 because: $50,63 due <br /> <br />( ) I am performing work on a property I own or occupy RECEIPT NO , <br />~ ) I am a registered builder OR ( ) the authorized ( ) The work will be performed by a registered builder <br /> representative of a registered builder ( ) Other (please specify) <br /> <br />REMARKS: <br /> <br />I have read this application ir; its entirety and certify that the stated information is true and correct to the best of my know/edge, <br /> <br />SIGNATURE OF APPLICANT: ............ <br />PLEASE NOTE: Driveway and sidewalk inspections are required by Public Works: 588.5036 <br />Other permits required by this dept: Plumbing ~ Electrical ~ <br /> <br /> <br />