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Appl. Recd,: __ <br /> <br /> MARION COUNTY <br /> DEPT. OF BUILDING INSPECTION <br /> Senator Building #225 4,64 <br /> 220 High St., N,E, 2nd Floor Permit No.;_ <br /> Salem, Oregon 97301 <br /> By: Dott~ e <br /> 588-5147 -- 588-5148 <br />,5:00 P,M ....................... CODE-A-Phone ...................... 8:00 A,M, <br /> <br />Date: 6/16/86 <br /> <br />Type of Permit: <br /> <br />Address: /Y',~ <br />Owner: <br /> <br />Bldr. & No' <br /> <br />Tax LOt No.: <br /> <br />Plans by: Phone; Address; ,, <br /> <br /> Map Page I ;:one I Zof~e Change Part, Cond. Use Variance/Adj. FT/FD Occupancy Type of Oonst, <br /> <br /> I <br /> I <br /> NO. Bdtm$, Min Req. Front Sides <br /> <br />Area of Bldg. 2nd Base- Total <br />Main Fir.: Fir,: merit: Area:- <br /> <br />Roof Type: <br />Heating <br />System: <br />Septic Tank <br />Site Eval.: <br />Exist, <br />System; <br /> <br />VALIDATIONS: <br />Zoning: <br />Date: __ <br /> <br />Wood <br />Stove: <br /> <br /> Va,uat,on: <br /> Bldg, Permit <br />Truss/Stick: Height- Fee: (+ 5%) / <br /> Water <br /> .Supply: Elect, Fee: ......... <br />New <br />Instal,: Mech. Fee: <br />No, <br />_Gals.: Plumb. Fee: <br /> State · <br /> Surcharge: (4%) <br /> Mechanical: <br /> Date: Plans Chk, Fee: <br /> <br />I agree tO build according to the submitted pla~send specifications, the laws of the <br />State of Oregon and the Ordinances of Marion County. PERMIT EXPIRES IF WORK <br />NOT 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 (please specify) <br /> <br />BLDG, <br />RECEIPT NO,; <br />Driveway <br />Permit Fee: <br />Site Plan <br />Review ~ee:. <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 /> PL~:ASE NOTE: Driveway and sidewalk inspection are required by Public Works; 588-5036 <br /> Other permits required by this dept.: Plumbing [] Electrical I-I Mechanical [] <br /> <br /> <br />