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MARION COUNTY <br /> DEPT. OF BUILDING INSPECTION <br /> Downtown Senator Building <br />AppJ Revd- /'~Lv,.2 )~ ~77 220 High St,,, N,E, 2ndFIoor PermitNo,, '~ <br /> Salem, Oregon 97301 <br />By;; R.H. WITHROW, BLDG. ADMINISTRATOR By:: ~ .......... <br /> 588-5147 - 588-5148 <br /> <br />Bldr & NO... ~.~'-'~' ~ ~ Phone:: Address;: <br /> // <br />Plans by;: Phone:: Address; <br />..............MapPaee [ Zone ZoneChg. _.~Part Co,d..Use Va¢i,,ce FireZone I Occ?y I Typeo, Const <br />u~e of md~ <br /> ................. / ........... <br />LotNo:: ~.,~ BIk,, No:: ~ ~- ~' ~ LotSize//~ ~ ~/Corner? <br /> <br /> Wa,er Supply;; Valuation;: <br /> <br /> ,, Stories / State e: <br /> <br />Basement Type;; .... Plans Chk, Fee;; <br /> <br />Heating p~..t~ <br />System:: ~ ......... <br /> <br />BTU:; Total Fees:: <br /> <br />I agree to build according to the submitted plans and spaclf/cations, the laws of the State of Oregon and the Ordinances of Marion <br /> <br />County, Permit expires if work not comm~in 120 days, <br /> <br />SIGNATURE OF APPLICANT: ~ ~"~/~"-/{.. ~ <br />VALIDATIONS: <br />ZONING SEPTIC TANK <br />By:: By:: <br /> <br />PLEASE NOTE: Driveway and sidewalk inspections are ~equired by Public Works, 588-5036 <br />Other permits required by this dept:: Plumbing I""1 Electrical Fi <br /> <br /> <br />