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MARION COUNTY <br /> DEPT. OF BUILDING INSPECTION <br /> Senator Building # 225 <br />Appl. Recd, t~JO"D~¥ 220 High St., N.E. 2nd Floor Permlt No, <br /> Oregon <br /> 97301 <br /> <br />Date: <br /> <br />Type of Permit: A~EQUAC¥ C;F~CE ONLY <br /> <br />Address:. 15043 O~OWA~I' NE AU~0iitA <br /> <br /> Tax Lot No: ....... <br /> <br /> Sec. ]'~, Twnshp. 6. Rge. '1~ <br /> <br /> SA~ 97002 <br />Address: ..... <br /> <br />Owne~EgtL~[~O Phone: 678-5388 <br />Bldr. & No,: Phone: Address: <br /> <br />Plans by; Phone: Address: <br />MapPage ' 7one3 ....... ZoneChg, [ Part, COnd. Ule I Variance, ,, ¢ireZone { Occupancy <br /> <br />U~e of Bldg,: No Bdrm~, ]L adCi Min Req. Front $ide~ <br /> RESZD:&NC~; e, o¢=. L~ 3 ex, et <br /> <br />Type of ConiC. <br /> <br />Lot No,: BIk. No,: Sub dv. <br />Area of Bldg. 2nd Base- <br />Main FSr,: F~r.: , merit: <br /> <br />Roof Type: Truss/Stick~ <br />Heating Wood <br />Sysfem~ Stove: <br />Septic Tank New <br />Site Evah Instal.: <br />Fxist, No, <br />System: ~r~ ~:: Gals.: <br /> <br />VALIDATIONS: <br />Zoning: Mechanical: <br />Date:____ ~q .... Date: <br />Septic Tank: I/?.~ e'~ ~ ,~ 4~7q Plans: <br />Date: _/~,~'~ ,,,~ ~_"- 0! __Date: <br /> <br />Lot Size <br /> <br /> Total <br /> Area: Vakmtion:__ <br /> Bldg, Permit <br /> , ,, Fee: ('4' 5%) <br />Water <br />Supply: CT~ Elect. Fee: <br /> <br />1000 GALLON <br /> <br />Mech. Fee: <br /> <br />Plumb. Fee: <br />State <br />Surcharge: <br /> <br />1 AC~.F. Corner? ~ <br /> <br />Plans Chk, Fee, ,,, <br />Septic Tank <br />Permit Fee: .~0-00 ~d~n~Lt~LCy <br /> <br />I agree to build according to the submitted plans and specifications, the laws of the State DEQ Surcharge: <br />of Oregon and the Ordinances of Marion County. Permit expires if work not commenced <br />within 180 days, I further expressly warrant that I comply with the provisions of ORS TOTAL FEE: <br />701.005 to 701,125 because: <br />( ) I am performing work on a property I own or occupy RECEIPT NO,: <br />( ) I am a registered builder OR ( ) the authorized ( ) The work will be performed by a registered builder <br /> representative of a registered builder ( ,) Other (please specify) <br /> <br />REMARKS: <br /> <br />PLEASE NOTE: ~riv~way ar~ si~walk inspections are required by Public Works: 588-5036 Other permits required by this dept: Plumbing [] Electrical [] <br /> <br /> <br />