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Appl Recd <br /> <br />By' ~F~S <br /> <br /> MARION COUNTY <br /> DEPT. OF BUILDING INSPECTION <br /> Senator Building #225 <br /> 220 High St. N,E, 2nd Floor <br /> Salem~ Oregon 97301 <br /> <br /> 588-5147 -- 588-5148 <br />Date. 8~ ~ -~ o~ ~ ~ ~ 500 PM CODE-A-Phone 8::00 Date 9-5-,95 <br /> <br />PermitNo:: 85-908~D <br /> <br />By;: PattF <br /> <br />Address:: <br /> <br />C~.~'~,/~__._ Tax Lot No. '. <br /> Sec:: ·~ r~,~ Twnshp / Pge / ~ <br /> <br />__Rhone::~ ~ Addre' t '~ss:: .......... <br /> Phone:; Address' <br /> <br /> drms-"~ I Mtn Req Rear <br /> <br />Use of BMS~ ~ <br /> <br /> Front <br /> <br />.Lot Si~e- --- · Corner. <br /> /...5 <br /> <br />Lot NO:: ..... RIk NO Sub.. dv <br />Area of Bldg 2nd Rase- <br /> <br />Total <br /> <br />Main Fir Fir:: ment:: Area <br /> <br />Roof Type __ Truss/Stick' Height;;. <br />Heating Wood Water <br />System Stove" Supply wel'l <br />Septic Tank New <br />Site Eva]..:: .instal <br />Exist No. <br />System:: __Gals :: <br /> <br />VALIDATIONS:: <br />Zoning Mechanical <br />Date::~ ~ h ~f)l ~ Date:: <br /> <br />Date:: ~ ~ - Date <br /> <br />Valuation:; <br />Bids Permit <br />Fee:: (+ 5%) <br /> <br />Elect Fee <br /> <br />Mech Fee:: <br /> <br />Plumb Fee <br />State ' <br />Surcharge:: <br /> <br />Plans Chk Fee <br />Septic Tank <br />Permit Fee:: <br /> <br />I agree to build according to the submitted plans and specifications= the laws of the <br />State of Oregon and the Ordinances 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 provisions of ORS 701005 to 701 125 because: <br /> <br />I am performing work on a property I Own <br /> <br />I am a registered builder OR ( ) the <br />authorized repreaentatlve of e <br />registered builder <br /> <br />) The work will be performed <br /> by a registered builder <br />) Other (please specify) <br /> <br />DEQ Surcharge' <br /> <br />TOTAL FEE:: <br />RLDG <br />RECEIPT NO <br />Driveway <br />Permit Fee <br />Site Plan <br />Review Fee:: <br />Public Works <br />Receipt No <br /> <br />REMARKS: <br /> <br />I have read this application in its entirety end certify that the stated information ia true and correct to the best of my knowledge <br /> <br /> PLEASE NOTE:: Dc7veway ar~sidewalk inspection ~quiref ~ <br /> by Public Works 588-5036 <br /> <br /> Other permits required bythmdept:: Plumbing ~ Electrical ~ Mechanical ~ <br /> <br /> <br />