|
By
<br />
<br />Date::
<br />
<br /> MARION COUNTY
<br /> DEPT. OF BUILDING INSPECTION
<br /> Senator Building #225
<br /> g20 High St, N,E,, 2nd Floor
<br /> Salem, Oregon 97301
<br />
<br /> 585-5147 -- 588-5148
<br />5 00 P,,M CODE-A-Phone 8::00 AM,
<br />
<br />Permit No:: 86-1318
<br /> E 464'2
<br />8y Chris
<br />
<br />Date. 12-30-86
<br />
<br />Type of Permit::__ ;!'~b47 '= :~cmc ~=~.~ss.::erlt =er I!,~?:D~,,i~> Tax Lot No
<br />
<br /> ' ' 7:9-7756 ~, s._m~.
<br />Owner ..... ~:~ -,~:,%?~ 3:"n- :) Phone:: _,, Y ~ao ross::
<br />
<br />Bldr & No s"m ~ _Phone:: Address'
<br />
<br />Plans by:: Phone:: Address
<br />
<br /> ~ ~ I~1t-- $~3
<br /> I
<br />
<br />Lot No ............... Elk, NO,;:
<br />Area of Bldg, 2nd
<br />Main Fir:: ......... Fir,
<br />
<br /> 7 ..X. ~ ye: s
<br />Sub dv .Lot Size:: __ __.Corner?.
<br />
<br />Base- Total
<br />
<br />Roof Type Truss/Stick:;
<br />Heating Wood
<br />System:: Stove
<br />Septic Tank New
<br />Site Eval,' __.instal,
<br />Exist No
<br />System y ." s .Gals,;:
<br />
<br />VALIDATIONS
<br />
<br /> Valuation::
<br /> Bidg, Permit ~c, °90
<br /> Height. Fee;: (+ 5%) .... ~.,'!,£Z~- ...............
<br />Water t~c!l
<br />.Supply:: Elect Fee:: 60,,fV'
<br />
<br />2 Lines
<br />
<br />Mesh, Fee
<br />
<br />Zoning ~ -~-'~'.,~ Mechamcal 3 F1 ~,et
<br />Date /],~--- ¢_;~'. ~--~' ~t;e _
<br />Septic Tank:: J¢~ ,. .~ ~ Pitons
<br />Date V~I J~.~ ~ Date
<br />
<br />I agree to build according to the submitted plans and specifications, the laws of the
<br />
<br />State of Oregon and the Ordinances of Marion County, PERMIT EXPIRES IF WORK
<br />NOT COMMENCED WITHIN 160 DA YS, I further expressly warrant that I comply with
<br />the provisions of ORS 701005 to 701,125 because,
<br />
<br />) The work will be performed
<br /> by a registered builder
<br />) Other (please specify)
<br />
<br />Plumb Fee
<br />State
<br />Surcharge _~(4°/°) ..... _3 ..~j_ _.
<br /> 7~t8
<br />
<br />Plans Chk Fee::
<br />Septic Tank
<br />Permit Fee
<br />
<br />DEQ Surcharge::
<br />
<br />) I sm 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 />TOTAL FEE
<br />BLDG,,
<br />RECEIPT NO
<br />Driveway
<br />Permit Fee
<br />Site Plan
<br />Review Fee
<br />Public Works
<br />Receipt No::
<br />
<br />_"-, r)"
<br />
<br />REMARKS ,,_ '_',,n!. ~ f,,,Tm
<br />
<br />t have read this application in its entir~y and certl[y that the~tated information is true and correct to the best of my knowledge,
<br />
<br /> PLEASE NOTE Drivew{~y and sidewgtlk ,nsp4cbon are required by Public Works:: 588-5036
<br />REV 7 as Other permits required by thisdept:: Plumbing Electrical Mechamcal
<br />
<br />
<br />
|