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Api~, Revd~ <br /> / / /.~ ./.? <br /> <br />Date' <br /> <br /> MARION COUNTY <br />DEPT. OF BUILDING INSPECTION <br />Senator Building # ;];25 <br />290 High St,, N.E. 2nd Floor <br /> Salem, Oregon 97301 <br />R.H. WITHROW, BLDG. ADMINISTRATOR <br />588-5147 - 588-5148 <br /> <br />Permit No. <br /> <br />By: <br /> <br />-? <br /> <br />Type of Permit: <br /> <br />BJdr. & NO,: ~ ~- Phone: <br />Plans by: ~ ~ Phone: <br /> <br />Tax Lot No: <br /> <br />Address; <br /> <br />Address; <br /> <br />Address: <br /> <br />,Twnshp. Rge, <br /> <br />Map Page Zone Zone Chg, Part, Cond, Use Variance Fire Zone Occupancy Type of Const. <br />Use of Bldg,'. No BdFvt~s. Min Rea, Front IS/dS/des. Rear <br /> <br /> No: No: / <br />Water Supi6iy: ~ <br />Sewage./o.~ ~.~--. ~/ Site <br />Disposal · ' ' Evah <br /> <br />Area of Bldg; ~_~'~ 2¢~3~',~ ~- ~:ories: <br /> Roof <br />Basement; Type; <br />Heating <br />System; <br /> <br />Permit Fee; <br /> <br />BTU: <br /> <br />/ State Surcharge; <br />  it Fee; <br /> <br />I agree to build according to the submitted plans and spec/f/cations, the /av~ of the State of Oregon and the Ordinancea of Marion <br /> <br />County, Permit expires if work not commenced within 120 days. <br /> <br />SIGNATURE OF APPLICANT: . __ <br /> <br />VALIDATIONS: <br />ZONING <br /> <br />B~ <br /> <br />Date: <br /> <br />Date: "~--.~- ~--'~L~ ( <br /> REMARKS <br /> <br />PLANS <br /> <br />PLEASE NOTE: Driveway and sidewalk inspections are required by Public Works: <br /> Other permits required by this dept: Plumbing [] Electrical <br /> <br /> 588-5036 <br /> <br />[] <br /> <br /> <br />