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Appl. Recd' Thurs <br />By: Chris <br /> <br />Bate: 8-1~85 <br /> <br /> MARION COUNTY <br /> DEPT. OF BUILDING INSPECTION <br /> Senator Buildiog #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 />Date; <br /> <br />PartU <br /> <br />8-20-85 <br /> <br />Type of Permit; <br /> <br />Address: <br /> <br />8763 Shaw Square Kd. gum. 97325 Sec.: <br /> <br />...~P %n e:.,, 58~-6966 Address: <br /> .Phone; ,,..Address; <br /> <br />Owner; 3 ,-,hr, <br /> <br />Bldr. & No.: <br /> <br />Tax Lot No,: <br /> <br /> _Twnshp.: <br /> <br />Plans by; <br /> <br />Use of eldg.: <br /> <br /> .Phone; --Address; <br />Pan' I C°nO' Use Variance/AdJ',, FI/FO ' Occupancy [Type °f COnst' L .... <br /> No. Bdrm,. I MinReq, Front I Sides I Rear <br /> or Ccc. Ld.: Setbacks', <br /> <br />Lot No.: BIk. NO.; <br />Area of BIdg, 2nd <br />Main Fir,: ,._Fir,: <br /> <br />Roof Type: <br />Heating Wood <br />System: ' _.. Stove: <br />Septic Tank <br />Site Eval,: <br />Exist. <br />System: <br /> <br />VALIDATIONS: <br />Zoning: <br />Date:, <br />Septic Tank: <br /> <br />Sub. dy.: _Lot Size:_ <br />Base- Total <br />__ ment: AreA: <br /> <br />Truss/Stick: ....... <br /> <br />New <br />Instal,: <br />No. <br />.Gals.; <br /> <br /> Mechanical: <br /> Date: <br /> Plans: <br />..__Date: <br /> <br /> Height:__ <br />Water <br />.Supply: <br /> <br /> _Corner?. <br /> <br />Valuation: <br />Bldg. Permit <br />Fee: (+ 5%) <br /> <br />Elect. Fee: <br /> <br />Mech. Fee:__ <br /> <br />Plumb. Fee: <br /> <br />State <br />Surcharge: (4%) <br /> <br />Plans Chk. Fee: __ <br />Septic Tank <br />Permit Fee: 35.00 <br /> <br />I agree to build according to the submitted plans and specifications, the laws of the <br />State of Oregon and the Ordinances of Marion County. PERMIT EXPIRES IF WORK <br />NOT COMMENCED WITHIN 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 sm performing work on a property I own <br /> or occupy <br />( ) I sm a registered builder OR ( ) the <br /> authorized representative of a <br /> registered builder <br /> <br />( ) The work w/Ii be performed <br /> by a registered builder <br />( ) Other (please specify) <br /> <br />DEQ Surcharge: <br /> <br /> 35.00 <br />TOTAL FEE: <br />BLDG. <br />RECEIPT NO,: <br />Driveway <br />Permit Fee: <br />Site Plan <br />Review Fee:__ <br /> <br /> Public Works <br /> ~ - Receipt No,: <br /> <br />I have PP ..... e y and certify that the stated information is true and correct to the best of my knowledge. <br /> <br /> PLEASE NOTE: ~y and s~dewalk inspection are required by Public Works: 588-5036 <br /> Other permits required by this dept.: Plumbing [2 Electrical I~ Mechanical El <br /> <br /> <br />