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DEPT. OF BUILDING INSPECTION <br />Appl. Reed= ,, ~I,~_.,~X~ 85-708 <br /> <br /> Senator Building # 225 <br /> 220 High St., N.E, 2nd Floor Permit NO, <br /> Salem, Oregon 97301 <br />By: Chris By: <br /> 588-5147 - 588-5148 <br />Date; 7/8/85 5;00 P.M.- ........... CODE-A-Phone 888-5373 ........... 8:00 A,M, <br /> Date: 7-17-85 <br /> <br />Type of Permit: Remodel - inter,or Tax Lot No: <br />Address; ~im Rdo N~. Aurura 97002 Sec,, Twnshp.__Rge. <br /> <br />Owner: ~chool Dt~t N. M~rion 15 Phone~7R.~R~ , ~dress: same <br /> <br />Bldr. & No.: B~ldwtn Const. Phone: ~ Address: 2!0 S, ~lm Canby 9 7013 <br /> <br />Plans by: PhoDe: Address: <br /> <br /> No Bdrm.. Min R~. Front ~es Rear <br /> <br />Lot No.: BIk. No,: Sub dv. <br />Area of Bldg. 2nd Base- Total <br />Main Fir,: FIr,= meet: Area: <br /> <br />Roof Type: Truss/Stick: <br />Heating Wood <br />System: Stove, . <br />Septic Tank New <br />,Site Evah Instal. <br />Exist. No. <br />System: Gals.. <br /> <br />Lot Size Corner';' <br /> <br />Voluotioe:_...A4~ 50_ 00 <br />Bldg. Permit 260.50 <br />Fee:(+ 5%) 13.03 <br /> <br />Water <br />Supply= Elect. Fee:. <br /> <br />Math. Fee~ <br /> <br />VALIDATIONS: <br />Zoning: Mechanical: <br />Date: ..... Date- Plans Chk. Fee: <br />Septic Tank: Plans~;~ 7-- //~ --(~" SepticTonk <br />Date: Dote:-.~~¢--~ Permit Fee: <br /> <br />Plumb, Fee: <br />State <br />Surcharge:. 10.42 <br /> <br />16g.30 <br /> <br />I agree to build according to the submitted plans and specifications, the laws of the State DEQ $urcharge, <br />of Oregon and the Ordinances of Morion County. Permit expires if work not commenced <br />within 180 days. I further expressly warrant that I comply with fha provisions of ORS TOTAL FEE.453-28 <br />701.005 to 70 I. 125 because: <br />( )l am performing work on ct property I ow, or OCCupy RECEIPT NO., {~)(~3~ <br />( ) I am a registered builder OR (~'~e authorized ( ) The work will be performed by a registered builder <br /> representative of a registered builder ( ) Other (please specify) <br /> <br />REMARKS: <br /> <br /> h ~ <br />I ave read this application~ety and certify thatt~h stated information is true and correct to the best of my knowledge, <br />SIGNATURE OF APPLICAN~~~"~ .... <br /> PLEASE NOTE/Odvew]~ and si~walk inspections are required by Public Works: 588-5036 <br /> Other/permits required by this dept; Plumbing [] Electrical [] <br /> <br /> <br />