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AppL Revd; ." <br /> <br />By: <br /> <br />Type of Permit: <br /> <br /> DEPT. OF BUILDING INSPECTION <br /> Senator Building # 225 <br /> 220 High St., N.E. 2nd Floor <br /> Salem, Oregon 97301 <br />R.H. WITHROW, BLDG. ADMINISTRATOR <br />588-5147 - 588-5148 <br />5::00 P.M.- .......... CODE-A-Phone 588-5373 ........... 8:00 AM, <br /> <br />Address: ,~l'~? ,UCCL~7,~',aN ~ ~T ~J~ Sec. <br />Owner: <br /> <br />Permit No. <br /> <br />By: <br /> <br />D te: <br /> <br /> Twnshp, ~ <br />Phone: eP6 8eSe Address: P~O~ N'E C~N'q'URV DR <br /> <br />Bldr. & No.: <br /> <br />Phone: Address: <br /> <br />Plans by: Phone: Address; <br /> <br />Mapo.~:Page ]/~(.}., :.Z°ne zone chg,, ] Pert,, Canal. U~ Vsrien~e I Fire Zone Oc~pen~ Ty~e of Co~,, <br /> <br /> No Bdrms. Min RN. Front Sides <br /> <br /> 'ubdv. ~ O~ Lo~Size ~O~'0~Corner?~ <br /> Valuation: <br /> <br />Use of 81dg.:: <br /> <br /> MN <br />L~t No: ~BIk. No: <br /> <br />Water Supply: <br /> <br />Disposal;; S~'TIC <br /> <br /> No,'-' <br />Aree of Bldg; 10 x L~O Stories; <br /> Roof <br /> no Type; <br /> <br /> Basement: <br />tallisH eating <br /> <br />o.,~ OTL FURNACE <br /> <br />BTU:: <br /> <br />Permit Fee: 3~,OO <br />State Surcharge: 1.40 <br />Plans Chk. Fee: <br />Septic Permit Fee: <br />Total Fees: <br />Rcpt. No; <br /> <br />VALIDATIONS: <br />ZONIN~ ~ S E PT ~.4N K PLANS <br /> <br /> m to the submitt~ plans and specifications, ~e la~ of ~e S~te of Or~on and the Oridnances of MariOn <br /> <br /> RECORD OF RgQUlRED INSPECT}-6N~ ..... <br /> Footing Forms:_ <br /> <br /> PJbg Grnd Wrk · <br /> <br />Imulation: Floor <br /> <br />Lath or Dry Wall: <br /> <br />Septic Tank & Drain Field~ <br /> <br />Final (Before Occupancy} g (~ ~ ~ ;-~3 ~Sewer- <br /> <br /> ' " ' ' · - 036 <br /> Other permits required by this dept: Plumbing ~ Electrical <br /> <br /> Wails: <br />-~tucco-Wire; __ <br /> <br />~~Heating:~ <br /> <br /> <br />