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Fire Zone -- <br /> <br />Type of Building <br />.. a,s of guilding <br /> <br /> DEPT. OF BUILDING INSPECTION <br /> Marion CounW <br /> <br />R.H. WITHROW, BLDG, ADMINISTRATOR <br /> 588-514.7 <br /> <br />APPLICATION FOR BUILDING PERMIT <br /> <br />Permit No. ~'.~- r.~ ~ '. <br />Valuation $ ~3 ~ 500.00 <br /> 97.00 <br />Permit Fee $ <br /> <br />Surcharge 2 ,,,9 ][ <br /> <br />Application is made to <br /> <br />ter a <br /> Demolish Structure <br />Repair <br /> <br />Address -- <br /> <br />5157 ]~more Dr. <br /> <br />Block I Addition <br /> <br />Lot si~ ___.2_~9% acre,. <br /> <br /> ,25.00 <br />Septic Tan k <br /> <br />Total Fee $ 124.91 <br /> <br />Cascade Park <br /> <br />#2 <br /> <br />Size of Bldg. <br /> <br />Number of Stories <br />Occupancy OF use <br />Se~,ag c Dispo~ol <br /> <br />residence <br /> <br />Heighl in feel ............... <br /> <br />sept. JrL c[ank <br /> <br />Water Supply -- <br /> <br />well <br /> <br /> Sdward Moore & Cli£Eord Dul/a~%dress <br /> )who,' <br /> <br />Builder & No ...... Ray Fo,.~er ~11165 Address -- <br /> Richard Vo~t <br />Architect Address -- <br /> <br />2511 Jory Hill Rd. $ <br />Salem <br /> <br /> 399-9705 <br />Phone -- <br /> <br />Conditional Use ..... Partitioning ........ <br /> <br />Variance Case No, __ <br /> <br />r - ..... t/-~ . <br />: APPLICATION RECEIVED ~ ..~;EPTIC TANK <br /> <br /> / "'~ ~ ~.~ / <br /> <br />L' ~-" Z ~&; -- :...__.~ i ~ <br />OTHER PERMITS REQUIRED BY THIS DEPARTMENT: Heating <br /> <br />ONLY WORK DESCRIBED ABOVE INCLUDED IN PERMIT <br />Jog rca lo t)uild cl¢¢ordin~4 fo ubove descriptior% p I cms and ~pe¢ificotion~ c;ndth o~~M~o <br /> u <br /> <br /> PLAN EXAMINER <br /> Appro.ve~-- Not A~proved <br /> <br />")o t e,¢~¢f''~c /7-7~_- <br /> <br />Plumbing <br /> <br />PERMIT ISSUED <br /> <br /> <br />