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MARION COUN I Y <br /> DEPT. OF BUILDING INSPECTION <br /> Senator Building # 225 <br />Appl, Revd: '~¢~-/~'~¢--"¢--~ 2')0 High St,, N,E. 2nd Floor Permit No. <br /> <br /> ,~ ,,2 Salem, Oregon 97301 <br />By: <br /> ' ~' / f-/~-~--/~--~ 5;;00 P.M.- ...........CODE-A.Phone 588-5373 ........... 8::00 A.M. Data__/. <br />Date: <br /> <br />Owner: F0~/ESS SIGN CO. Phone: <br /> <br />81dr. & No.;; ~ me Phone: <br /> <br />Plans by: Phone: <br />E4ap Page Zone Zone Chg. ' '"~r[,. Co~d. <br /> <br />92.8..-5858 Address: 302155 HIGHWAY 3b, ALBANY <br /> <br /> .... Address: ~//~.~,~ ~ ~J~ 97321 <br /> Address; <br /> <br />Lot No; BIk No: Sub dv. <br /> <br />Water Supply: <br />Sewage Site <br />Disposal: Eval: <br /> No- <br />Area of Bldg: ] ? × I 5 Stories;. <br /> ~ ~%j. / ~ Roof <br />Basement: Type: <br />Heating <br />System:: <br /> <br />Valuation; <br /> <br />Permit Fee~ <br /> <br />State Surcharge: <br /> <br />Plans Chk, Fee; <br /> <br />,~eptic Permit Fee; <br /> <br />Lot Size Corner~ <br /> 3000.00 <br /> <br /> 35.65 <br /> <br />1.43 <br /> <br />BTU: Total Fees: 37.08 <br /> Rcpt. No: ~ <br /> <br />VALIDAT4ONS;: <br />ZONINGe~¢,. ~ SEPTICBy:: TANK PLANSBy;; ~ <br />I agree to build ~ccording to the ~ubmitted plans and specifications, the Ja~ of the State of Or.on and the Oridnance~ of MariOn <br />County, Permit expires if work not commenced within 120 day~, I furhter expr~sly warrant that I comply wi¢) the prows)Ohs of ORS <br />701,,~5 ro 701,, 125 b~ause <br />( ) lamar~lsteredbui~deror( ) theauthor~zedrepresentativeofar~icter~builder <br /> <br />( ) Theworkwi/Ibeperformedbyaregisteredbui/der <br />( ) I am performing ~vOrk On a p~operty I own or occupy <br />Other (p/ease ~/y) <br /> <br />SIGNATURE OF APPLICANT;; .~E~-CY--~L~ <br />PLEASE NOTE: Driveway and sidewalk inspections are required by Public Works; 588-5036 <br />Other permits required by this depu Plumbing E~] Electrical <br /> <br />to the best of my know/edEe <br /> <br /> <br />