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Appl Reed _ ..... <br />By <br />Date <br /> <br /> .MARiON.COUNTY <br /> DEPT. OF BIJII~DING INSPECTION <br /> Senator Building #225 <br /> 220¢tigh St,,, N,E 2nd Floor Permit No <br /> Salem, Oregon 97301 <br /> 588-5147 -- 588-5148 By::__ <br /> <br />5::00 PM .... CODE-A-Phone 8::00 AM <br /> Date:: <br /> <br />Type of Permit:: .... ~,iJ_d±Ttg <br /> <br />.Tax Lot No 40361-000 <br /> <br />Address 13504 £hlen g~..,,,,,_~.~...A.u_~o_~.a~o~ 97002 Sec ~.~. Twnshp <br /> <br />Owner:: <br /> <br />Rldr & NO <br /> <br />Susie ~.,...E, gke~ Phone 263-6089 Address P.O. Box 433 <br />ADAIR 1~0[¢L6S~'-:1~. Phone::_~,,.4,~J,J,,.5,,6 .... Address::~.W. 170th, Bmmvmrenn: OR 97006 <br /> <br />Plans by:: Adair Homes, Inc. Phone Address:: <br />MBPPage I Zone [ Zoncchangc1 Part Cond Use V'arance/Adl FTfFD <br /> <br /> I <br /> <br />Use of BIO~ No Bdrms <br />Sing~,e Family Dwelling or Ccc Ld <br /> <br />3 Setbacks <br /> <br /> Single Faro. New <br />~ron~ J Sides ......... --R-e~-¢ -'- <br />53' 25'&107' 385' <br /> <br />Lot NO _BIk No ........ Sub dv:: <br />Area of Bldg 2nd Base- Total <br />Ma n F r __105.6_S~FIr, 624 sf _ment:: Area 1680 sf <br /> <br />Roof Type~- g ...... Truss/Stick Truss <br /> <br />Heating Cadet Wail Wood Water <br />System ,~i~g~ters Stove:: __ __.Supply <br />Septic Tank New <br />Site Eval See attached __.instal Yes <br />Exist, No <br />System:: .... Gals:: <br /> <br />Height <br /> <br /> Well <br /> <br />24' <br /> <br />VALIDATIONS <br />Zoning:: Mechanical <br />Date .Date:: <br />Septic Tank Plans:: <br />Date Date __ <br /> <br />LotSize 2 acres ,Corner? <br /> <br /> Valuation $54.406.00 <br /> Bldg, Permit <br /> Fee:: (+ 5%) <br /> <br /> Elect, Fee:: <br /> <br /> Mech Fee <br /> <br /> Plumb Fee <br /> State <br /> Surcharge::. (4%) <br /> <br /> Plans Chk, Fee <br /> Septic Tank <br /> Permit Fee:: __ <br /> <br />I agree to buiid 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 />NOT COMMENCED WITHIN 180 DA YS I further expressly warrant that ! comply with <br />the prows¢ons of ORS 70~ 005 to 701 125 becauae: <br /> <br />( Z ) I am a registered builder OR ( ) the <br /> registered builder <br /> <br />( ) The work will be performed <br /> by a registered builder <br />( ) Other (please apecify) <br /> <br />DEQ Surcharge:: <br /> <br />TOTAL FEE:: <br />BLDG <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/~'~lcertifYl.~hatjhe stated Information ia true and correct to the best of my knowledge <br /> <br />SIGNATURE OF APPLICANT ~,7.~.....~~.// ¢.~f~. ,.¢~.~...~~ <br /> PLEASE NOTE D~;ay and sidewalk i.spec;:;~';re required by Public works 588-5036 <br /> Other permits required by this dept, Plumbing ~ Electrical D Mechamcal B <br /> <br /> <br />