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Chris <br />8y <br /> <br />Date 5-20-86 <br /> <br /> MARION COUNTY <br /> DEPT. OF BUILDING INSPECTION <br /> senator Building #225 <br /> 220 High St,,~ NE ~'nd Floor Permit No 86-505 <br /> Salem, Oregon 97301 <br /> 588-5147 -- 588-5148 Ry Pat~ -- <br /> <br />5'00 PM ....... CODE-A-Phone 8;:00 AM <br /> Date 6-9-86 <br /> <br />Type of Permit' <br /> <br />Address .... <br /> <br />Owner <br /> <br />Bldr, & No <br /> <br />Site dv~luation <br /> <br />TaxLotNo ,.,, 5650C-000 <br /> <br />11742 Steinkamp Rd. SE ~% 32 8 <br /> , , .,~k~ Sec', Twnshp <br /> T~mo%hy Hampton E~ 585-~325 2117 Nomed Ct. <br /> Phon f ~ ~ Address,__ <br /> <br /> Phone:: ...... Address <br /> <br /> Rge __ <br />S~ 9?306 <br /> <br />Plans by <br /> <br />Phone Address;:__ <br /> <br />Map~,aPage l ZOne~ <br /> <br />Zone Change <br /> <br />or DOC Ld Min Req Front I Sides I Sear <br />No ¢Jdtms ~ Setbacks <br /> <br />Lot No _Blk, No <br />Area of Bids 2ed <br />Main Fir :: Fir,,' <br /> <br />~Sub dy <br />Rase- Total <br />_lent:: Area:: <br /> <br />Roof Type Truss/Stick; <br />Heating Wood <br />System Stove' <br />Septic Tank New <br />Site Eval .... Instal, <br />Exist No,, <br />System .... Gals ;: <br /> <br />VALIDATIONS' <br />Zoning Mechanical:: <br />Date:: ~ ¢ ~ Date:: <br />Septic Ten k [/'~J~''~ &--G~& Plans <br />Date, ~.X.d .Date;: <br /> <br /> ~.~Heig ht::_ <br />Water <br /> well <br />.Supply <br /> <br />,LotSize_ 250 × A__~rner? no <br /> <br />Valuation, <br />Bids,, Permit <br />Fee:: (+ 5%) <br /> <br />Elect Fee <br /> <br />Moth, Fee:: ..... <br /> <br />Plumb Fee:: .... <br />State <br />Surcharge::. (4%) <br /> <br />Plans Chk, Fee __,, <br />Septic Tack ~, <br /> 1 ,C.00 <br />Permit Fee:: <br /> <br />I agree to build according to the submitted plans end specifications:, the laws of the <br />State of Oregon and the Ordinances of Marion County PERMIT EXPIRES IF WORK <br />NO T COMMENCED WI THIN 180 DA YS, I further expressly warrant that I comply with <br />the provisions of ORS 701005 to 701,125 because; <br /> <br /> ) I am performing work on a property I own ( ) The work will be performed <br /> or occupy by a registered builder <br /> ) I am a registered builder OR ( ) the ~ ) Other (please specify) <br /> authorized repr~ t~ o~ <br /> <br /> cc,,nst~uct~::m p~un~ts must first be obtained <br /> ~io~e building <br /> <br />REMARKS,,,, ' ' <br /> <br /> %5.00 <br />DEQ Surcharge:: <br /> <br /> 15~.00 <br />TOTAL FEE' <br /> <br />RECEIPT NO <br />Driveway <br />Permit Fee <br />Site Plan <br />Review Feet <br />Public Works <br />Receipt NO __ <br /> <br />I have read this application in its entirety end certify that tl/ed i%tlon is true and correct tO the best of my knowledge <br /> <br /> Other permits required by this depth Plumbing ~ Electrical B Mechanical B <br /> <br /> <br />