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"~///~ MARION COUNTY <br />  ~ DEPT. OF BUILDING INSPECTION <br /> ,~7/"~ . ,~j,,' Senator I~ild~ng # 225 545 <br />~pl. Reed: '/ ~~ 220 High St., N.E. 2nd Floor PermR No. <br /> <br />Date: ~ 5:00 P.M; ............ CODE-A-Phone 588-5373, .......... 8:00 A.M. Date: <br /> . , .................. <br />Type ~)f Permit:~ ~/~ ,TaxLotNo: <br /> <br />Plans by: Phone: Address: <br /> MeePage I Zone Zone Chg. Pert. Canal, Uae i Variance I FireZon. I Occupancy Type of Con~. <br /> <br /> NO Bdtmtt, Min Req, Front gides Rear <br />Use of Bldg.: or acc, Ld: S,,backs; I J <br /> I <br /> <br />Lot NO,:, ____BIk, No,: Sub dy. <br />- Area of Bldg. 2nd <br /> Main Fir., 30~36 Fir.: <br /> <br />Roof Type: metal <br />Heating <br />System~ <br />Septic Tank <br />Site Evah <br />Exist. <br />System: <br /> <br />Floor: concrete slab <br /> Truss/Stick: truSS <br />Woad Water <br /> Stove: -- Supply:. <br /> New <br /> Instal.: .......... <br /> <br /> Gals,: <br /> <br />VALIDATIONS: <br />Zoning: <br />Oate~ <br />Septk <br />Date:_ <br /> <br />I agree <br />of Oreg, <br />within l~ <br />701. 005 <br />( )/amp <br />( )lama <br /> <br />Total <br />Area, 30RO ~a. E~-. <br /> <br />Lot Size 160x450 Corner?. no <br />Voluatiom ~-~ ~:~ <br />Bldg. Permit ~.,~,~, ~,~ <br />Fee: (+ 5%~ <br /> <br />Elect, Fee: <br /> <br />Mech, Fee: ........ <br /> <br />REMARKS;_ <br /> <br />I have read this application io its <br /> <br />,tions, the laws of the State <br /> 'es if work not commenced <br /> 'th the provisions of ORS <br /> <br />Plumb. Fee: <br />State <br />Surcharge: <br /> <br />Plans Chk, Fee: <br />Septic Tank <br /> <br />Permit Fee; <br /> /. <br />DEQ Surcharge: <br /> <br />TOTAL FEE: <br /> <br />RECEIPT NO- <br /> <br /> ' ) The work will be performed by a registered builder Other (please specify) <br /> <br />and certif 'he stated information is true and correct to the best of my know/edge. <br /> <br />SIGNATURE OF APPLICAN'~ <br /> <br /> PLEASE NOTE: Driveway and sidewalk <br /> <br /> Other ~uired by this dept; P ]mbing <br /> <br /> 588-5036 <br />[] Electrical [] <br /> <br /> <br />