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L L <br />Appl. Revd: <br /> <br /> 51. <br /> <br />Dat~;; <br /> <br /> MARION COUNTY <br /> DEPT. OF BUILDING INSPECTION <br /> Senator Building ~k225 <br /> 220 High St., NE. 2nd Floor <br /> Salem, Oregon 97301 <br /> R,H. WiTHROW, BLDG. ADMINISTRATOR <br /> 688-5147 - 588-5148 <br />500 P.M.- ........... CODE-A.Phone 588-5373 ........... 8-00 <br /> <br />Type of Permit;; <br /> <br /> ;.3 ,~.(L~ ,D. 3.~. U;~bV-li LE <br /> <br /> I ; 7£.9-> 225 <br />Owner:; Phone: <br /> <br /> sec, wnshp, q: .ge <br />Address: <br /> <br />Bldr, & No,: ' ::'; ,,02.~1£,~N, :,,: .,: Phone; Address: <br /> <br />Plans by: Phone;: Address:: <br /> <br />Map Page Zone <br />Use~of ~dg,,:; r <br /> <br />Zone Chg, Pert,, Cond,, U~e Variance J <br /> Cb, 8¢ -4 0 <br /> Min Req. <br /> <br />Lot No:: <br /> <br />,BIk, NO::--. SUb dy, <br /> <br />Water Supply: <br />Sewage =;, Ill, Site <br />Disposal::_ Evah <br /> <br />Area of Bldg; <br /> <br />Heating <br />System:; <br /> <br />Stories;. <br />Roof <br />Type;; <br /> <br />Valuation; <br />Permit Fee;; 35.00 <br />State Surcharge;; 1 <br />PLans Chk. Fee:; <br />Septic Permit Fee:: 160,.00 <br /> <br />BTU; Total Fees; <br /> <br /> Rcpt.. No:; <br /> <br />VALIDATIONS:: <br />ZONING //~)..,~ SEPTIC T/~/'J _ <br />B~:; ( ,~'~"~..",-~_. <br /> <br />196,~0 <br /> <br />PLANS <br /> <br />I agree to build accordinq to the submitted plans and specifications, tl~e I~w$ of the State of Oregon and the Oridnerlce~ of M,~rion <br />County Permit expires if work not commenced withi~ 120 days I furhter expressly warrant that I comply with the provi$ibns of ORS <br />701 005 to 701 125 because; <br />( ) lamaregisteredbuilderor( ) ~eau~orizedrepresentativeofar~i~ter~buflder <br />( ) The work wiTI be pe~orm~ by a r~istered builder <br />( ) lampeHormi&qworkonapropertylownoroccupy <br /> <br />SIGNATURE OF APPLICAN <br /> PLEASE NO'Drily and sidewalk insp~tions are required by Public Works;; <br /> Other permits required by this dept;; Plumb~g <br /> <br /> <br />