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AppL Rev(J. Tuesday <br />D_ate:: 7~31~'~9 , <br /> <br /> MARION COUNTY <br /> DEPT. OF BUILDING INSPECTION <br /> Senator Building # 225 <br /> 220 High St,,, N,E, 2nd Ftoor <br /> Salem, Oregon 97301 <br />R.H. WITHROW, BLDG. ADMINISTRATOR <br />588-5147 - 588-5148 <br /> <br />By _ <br /> <br />Date:, <br /> <br />Add,ess:: ~ bhaw ;,quare ~d. -~.~. <br /> <br />John Masser <br /> <br />Phone;; 749-2850 <br /> <br /> Sec _~3./~.~,].'Tw]~hp . 8 Rge <br />Address 8774 ~haw 3quBz'e F.d. :,,.~. <br /> <br />Bldr & NO,,. Phone:: Address:: <br /> <br />Plans by:: Phone:: <br /> L .....a <br /> .~p~0 ~t~e ~ 'One Chg Part Cond Variance <br />Us~ of'Bid-¢ No Bdr~ <br /> ;¢ite evaluation <br /> <br />Address. <br />Fire zone-'---"¢- oecui3~¢ ....... :~D~ ~f Con*t <br />/ <br /> <br />Lot No:: __BIk No::~ __ Sub dy,, <br /> <br />Lot Size 8 ,'-.cres Corner? __ <br /> <br />Water Supply;: Valuation: <br />Sewage ~ ~ Site <br />Disposal s~- ce eval. Eval:: Permit Fee; <br /> No. <br />Area of BId_q Stories::. State Surcharge:: <br /> Roof <br />Basement:: Type:: Plans Chk, F~e:; <br />Heating <br />System:; Septic Permit Fee;: <br /> <br />37.50 <br /> <br />BTU <br /> <br />Total Fees;; <br />Rcpt. No:; ~g 7/ <br /> <br /> agree to boild according to the sub~d plan.{ and apeclflcation$, the law~ of the State of Oregon and the Ordinances of Marion <br />:'~;::~N:r APP LICANT:; '~fT:~ ' /'~¢ :'--~-~ ~~· PLAN ............... <br />ZONIN&~ <br /> <br /> REMARKS <br /> <br /> Stop at house at 877& Shaw Square Rd. ~.~. and someone will show you where to <br /> <br />~o un property. <br /> <br />PLEASE NOTE:: Driveway and sidewalk inspections are required by Public Works:: 588-5036 <br />Other permits required by this dept;; PhJmbing [] Electrical EJ <br /> <br /> <br />