Laserfiche WebLink
Appl Recd <br /> <br />By:: <br /> <br />Date <br /> <br /> MARION COUNTY <br /> DEPT. OF BUILDING INSPECTION <br /> Senator Building #225 <br /> 220 High St, N,E, 2nd Floor <br /> Salem, Oregon 9730t <br /> <br /> 588-5147 -- 588-5148 <br />5;:00 PM CODE-A-Phone .......... 8;:00 AM <br /> <br />Permit No:: <br />By <br /> <br />Type of Permit:: ~i{O}'i FOUNDATION ~:~ ADDITION TO ~SIDF.~'~C~, .Tax Lot No <br /> <br />Address;: .~11576 MOOL~%LAN LA~T~ SE Sec::_ 3 Twnshp, <br /> <br />Owner GL~ LA;~SON Phone::_.~69-7169 Address:: SA~E <br /> <br />75440-~20 <br /> <br />9 _Rge :: ~w <br /> <br />Bldr & No::. S'A'A~ _Phone ,Address <br /> <br />Plans by _Phone:;__ Addrese:: <br /> Zone CPange Part Good Use ~/ariancefAdj FT~FD Occupancy Type of Const <br /> <br /> USe of a~d~ r~c~ '~ ad8 SetbacksMin Boq FrontI Sides Roar <br /> <br />Lot No .BIk No Sub dy::. __Lot Size ~('1¥1PO Corner? ~..~ . <br /> <br />Area of Bids 2nd Base- Total <br />Main Fir ~h- Fir _ment ,,, Area ~;~..~ Valuation I~;&RC~.©¢) <br /> Bids, Permit 98.50 <br />Roof Type ,~'~ED, Truss?Stick, ~m~t!.~He~ght Fee:: (+ 5%) 14-.~...~ <br />Heating Wood Water <br /> <br />System:: ~, ~ ~ -r ~ ~ ....... ? Supply:: T'~j~-,Ti Elect Fee:: <br /> <br />Septic Tank New <br />Site Eval,;: __ .Instal:: Mech Fee:; <br /> <br />Exist No <br /> YES ? <br />System Gals,:: <br /> <br />VALIDATIONS <br />Zoning:: Mechanical:: <br />Date:: Date:: <br />Septrc Tank' Plans:: <br />Date .Date:: <br /> <br />State of Oregon and the Ordinances of Marion County PERMIT EXPIRES IF WORK <br />NO T COMMENCED WI THiN 180 DA YS I further expressly warrant that I comply w~th <br />the provis~ons of ORS 707,005 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 pertormed <br /> by e registered builder <br />( ) Other (please specify) <br /> <br />34.o0 <br /> <br />Plumb Fee <br />State <br /> i o,o) <br /> <br />Plans Chk,, Fee' 64.03 <br />Septic Tank <br />Permit Fee .............. ~ ,0.~ O0 <br /> <br />DEQ Surcharge <br /> <br />TOTAL FEE:: <br />BLOG <br />RECEIPT NO <br />Driveway <br />Permit Fee <br />Site Plan <br />Review Fee:: <br />Public Works <br />Receipt No <br /> <br />5°00 <br /> <br />U~ON COMPLETIOM OF HOU5~o <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 />SIGNATURE OF APPLICANT:; <br /> <br /> PLEASE NOTE Driveway and sidewalk inspection are required by Public Works 588~5036 <br /> <br /> Other permits reqmred by this dept :; Plumbing [] Electrical [3 Mechanical [] <br /> <br /> <br />