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Appl Recd :: i¢'ON <br />By C..~. <br />Date:: <br /> <br /> MARION COUNTY <br /> DEPT. OF BUILDING INSPECTION <br /> Senator Budding #gg5 <br /> 220 High St,,, NE 2nd Floor <br /> Salem= Oregon 97301 <br /> <br /> 588-5147 -- 588-5148 <br />500 P M CODE-A-Phone 8'00 AM <br /> <br /> BLDG. # 85-334 <br /> <br /> ELEC. # 867 <br />Permit No __ <br /> <br />By__ PATTZ <br /> <br />Type of Permit. ~O,3rI=.%; r-[k~M;£ £LAC~'~T <br />Address xL :' <br /> <br />Owner:: D,~) ~-~; ~y Phone:: <br /> <br /> Tax Lot No,, <br /> <br />__ Sec <br /> <br /> Address <br /> <br />__.Rge lw ..... <br /> NE SP }4 <br /> <br />Phone .... ~ddress <br /> <br />Plans by __ __ Phone Address <br /> <br /> Map Page Zone Zone Change Part Cons USO Yariance/Adj FT/FD Occupancy f'yO¢ of Consf <br /> <br />Use of Bldg No Bdrms Min aeq Front [ Sides Rear <br /> .,, or Ccc Ld Setbacks <br /> <br />Lot NO .P-...Elk NO Sub dy SINOR ~,~].S_'2.\'Z'],~S Lot <br />Area of Bldg 2nd Ease- Total ,P.~ x 60 <br />Main Fir :: __Fir __ meet Area .......... <br /> <br />Roof Type Truss/Stick... Height <br />Heating Wood Water <br />System ....... Stove Supply <br />Septic Tank ,:SU3 81-_5.5LI New <br />S~te Eval .Instal <br />Exist NO. <br />System __ ...Gals. <br /> <br />VALIDATIONS:: <br /> <br />Size .ql ~C Corner? .. no <br /> <br />Valuation_ <br />EIdg Permit <br />Fee (+ 5%) <br /> <br />Elect Fee:: <br /> <br />Mech. Fee__ <br /> <br />Plumb Fee <br />State <br />Surcharge (4%) <br /> <br />Plans Chk Fee <br />Septic Tank <br />Permit Fee:: 7.5~ O© <br /> <br />I agree to build according to the submitted plans and specifications, the laws of the <br />Slate of Oregon and the Otdinances of Marion County. PERMIT EXPIRES iF WORK <br />NO T COMMENCED WITHIN 180 DA YS I further expressly warrant that I comply with <br />the prows¢ons of ORS 701.005 to 701 125 because <br /> <br />( ) I am performing work on a property I own <br /> or occupy <br />( I I am a registered builder OR ( ) the <br /> authorized representative of a <br /> registered builder <br /> <br />DEQ Surcharge" __ <br /> <br />5. O0 <br /> <br /> TOTAL FEE __ 176o10 <br /> BLDG <br /> RECEIPT NO ~ ~10/___ <br />( ) The work will be performed Driveway <br /> by a registered builder Permit Fee /~ ~ ~ <br />( ) Other (please specify) Site Plan <br /> Rewew Fee. <br /> Public Works <br /> Receipt No:: <br /> <br />REMARKS <br /> <br />PLEASE NOTE Driveway and sidewalk ir~spect;on-~re required gPubtJo Works:: 588-5036 <br />Other permits required by thisdept Plumbing [] Elect¢cal [] Mechanical [] <br /> <br /> <br />