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~ . BUILDING INSPECTION <br /> <br /> R¢C~d. ~igh St,, N.E. 2nd Floor Permit No.: <br />Dppr. i,,. , <br /> 588-5147 ~ 588-5148 By: <br /> <br /> ~UIL~ ~ ~ ~D~r m. Date: <br /> <br />Plans by: Phone:_ Address; <br /> <br /> 'Use of Did .: NO. B¢rms, <br /> <br /> ~,' <br />Lot No,:_ BIk. No,; _Sub. dv.: <br />Area of Bldg, 2nd Baae- <br />Main Fir.: _ __Fir' .merit: <br /> <br />Total <br />Area; <br /> <br />Roof Type; , Truss/Stick; <br />Heating Wood <br />System: __,Stove: <br />Septic Tank New <br />Site EvaL; __ ItletaL: , <br />Exist. No, <br />System: Gals.: <br /> <br />Height; <br /> <br />.Water <br /> <br />VaJuation: <br />Bidg, Permit <br />Fee: (* 5%) <br /> <br />Elect. Fee: <br /> <br />VALIDATIONS: <br />Zoning: j~ ! ~ Mechanical: <br /> <br />SepticTank: Ill/Y-- Il 0 n Pla,s: <br />Date: Ill/Il j ~' ~.-v /~ / Oate: <br /> <br />/ a~r~e to build aooording to the submitted plan8 and specifi~ation8, the laws of the <br />State of Oregon a~d the Ordinances of Marion County, P~RMIT ~XPl~g8 IF WORK <br />NO T OOMM~NOgD WITHIN 180 DA YS, I further expreggly warrant that I comply with <br />the provi~ion~ of OR8 701,00~ tO 701, ~26 because: <br /> <br />( ) The work will be performed <br /> by e registered builder <br />( ) Other (please specify) <br /> <br />( ~ I am performing work on a property I own <br /> or occupy <br />( ) I am a registered builder OR ( ) the <br /> autdor/zed representative of a <br /> registered builder <br /> <br />Plumb, Fee: <br />State <br />Surcharge; (4%) <br /> <br />Plans Chk. Fee: <br />Septic Tank <br />Permit Fee: <br /> <br />DEQ Surcharge: <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 its entirety and certify that the stated information is true and correct to the best of my knowledge. <br /> <br /> PLEASE NOTE: Driveway and sidewalk inspection are required by Public Works: 588-5036 <br />/~c ~ s. ~ Other permits required by this dept.: Plumbing ~3 Electrical ~ Mechanical D <br /> <br /> <br />