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Appl, Recd.: <br /> <br /> ~ot~e <br />By: <br /> <br />Date: 2/27/85 <br /> <br /> MARION COUNTY <br /> DEPT. OF BUILDING INSPECTION <br /> Senetor Building #225 <br /> 220 High St,, N,E, 2nd Floor <br /> Salem, Oregon 97301 <br /> <br /> 588-5147 -- 588-5148 <br />5'.00 P.M ....................... CODE-A-Phone ...................... 8:00 A,M. <br /> <br />Permit No.: <br /> <br />By: <br /> <br />Date: <br /> <br />3~18-85 <br /> <br />Type of Permit:L Press box <br />Address:_ 20167 Grim <br /> <br />Owaer; <br /> Bruce Rafn <br /> <br />BIdr. & No.: same <br /> (school projeot) <br />Plans by: <br /> Map Page [~ Zone ChangeI Part. <br /> <br />North Marion Hish School ,,.Phone: 982-9887 <br /> <br /> Phone; <br /> <br /> Phone; ,, <br /> <br /> Tax Lot No,: <br />Sec,: ~'~ ~,,,,,,,Twnshp.: <br /> <br /> Address: same <br /> <br /> Address: <br /> <br /> Address;___ <br /> <br />om' 0¢6. Ld.: SetbaOkS; <br /> <br />Lot No.: BIk. NO.: <br />Area of Bldg. 2nd <br />Main Fir,: ,Fir.: <br /> <br />Roof Type:_ metal <br /> <br />Heating Wood <br />System: .Stove: <br />Septic Tank New <br />Site Eval.: Instal,: <br />Exist, No, <br />System; ..... Gale.: <br /> <br /> Sub. dv,:__ <br /> Base- Total <br /> ment; ..... Area: ?0 sq Ct. <br /> 2 etory <br />Truss/Stick: ~t&c~ Height: 15t <br /> water <br /> Supply: <br /> <br />VALIDATIONS: <br />Zoning:_.. / /.~ ~ _~ Mechanical: <br />Date;-~?/.f~;/.'f,C-/~_..-/_~, ,Date: <br />Septic Ta'n I~: <br />Date: ...... <br /> <br />I agree to build according tO the aubmitted plane and specifications, the laws of the <br />State of Oregon and tho Ordinances of Marion County. PERMIT EXPIRES IF WORK <br />NO T COMMENCED WI THIN 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 /> author/zed representative of a <br /> registered builder <br /> <br />( ) The work will be performed <br /> by a registered builder <br />( ) Other (please specify) <br /> <br />Lot Size; Corner?__ <br /> <br />Valuation: ,,. .500. <br />Bide, Permit 10,00 <br />Fee: (+ 5%) ~ <br /> <br />Elect. Fee; <br /> <br />Mech. Fee: <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 /> 10.50 <br />TOTAL FEE: .... /!/¢_?~J <br />BLDG. <br />RECEIPT NO ' 3228 <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 appliaati°n in it~ ieltify~~ted inf°rmati°n ia true and c°rrect t° the best °f my kn°wledge' <br />SIGNATURE OF APPLICANT: __ ./~"'~-',~'.,-~. ~ ,r b' Pubilc Works <br /> PLEASE NOT~ and side~w~lk inspection are requ' ed y ' : 588-5036 <br /> Other permits required by this dapt.; Plumbing El Electrical [] Mechanical E] <br /> <br /> <br />