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MARION COUNTY <br /> DEPT. OF BUILDING INSPECTION <br /> Senator Building # 225 <br />A~I~I,, Reed: 220 High S~,,. N.E. 2nd Floor Permit No. <br /> Salem, Oregon 97301 <br />By: By: <br /> 588-5147 -- 588-5148 <br /> ~('- _~ ~ _ ~- 5:00 P,M,- ........... CODE-A-Phone 588-5373 ........... 8:00 A,M, <br />Date: <br /> Date: <br /> <br />85-618 <br /> <br />Patty ....... <br /> <br />6-24-85 <br /> <br />Type of Per it: ~'l ~ <~3~C~.~'FID~.} Tax Lot No: <br /> <br />Bldr, & No,: Phone: Address: <br /> <br />Plans by: <br /> Map P~ge <br /> <br />J '"'"'"~ne Zone Chg <br /> <br /> Phone: Address: <br />~rt,, I cond. u~e I v*f~n~e I FireZon. t Occupancy I TvPeafCan~, <br />Min Rea,, FrOnt Side~ Rear <br /> <br />Lot No: BIk. Mo.~ -- Sub dy. <br />Area of g~dg 2nd Base- <br />Main Fir= .... Fir,,: , ment: <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 />Total <br />Area:__ <br /> <br />Water <br />Supply, t~{ ~t~/ <br /> <br />VALIDATIONS= <br />Zoning: /~/1 Mechanical: <br />Dote:. /! II Dater <br />Septlc Tank=~Date= ~ --~"~ Date= Plans: <br /> <br />I agree fo build according to the submitted plans and specifications, the laws of the State <br />of Oregon and the Ordinances of Marion County,, Permit expires if work not commenced <br />within 180 days,, I further expressly warrant that I comply with the provismns of ORS <br />70~.005 fo 701 125 because= <br /> ) I am performmg work on a property I own or occupy <br />( <br /> <br />Lot Sixe~Corner? <br /> <br />Valuation:. <br />Bldg. Permit <br />Fee: (+ 5%) <br /> <br />Elect. Fee:. <br /> <br />Math, Fee~. <br /> <br />Plumb, Fee: <br />State <br />Surcharge:__ <br /> <br />Plans Chk. Fee= <br />Septic Tank <br /> <br />DEQ Surcharge~.- <br /> <br />TOTAL FEE: <br /> <br />) I am a registered builder OR ( ) the authorized ( ) The work will be performed by a registered builder <br />representative of a registered builder ( ~ Other (please specify) <br /> <br />REMARKS:: <br /> <br />I have read this application in its entiYety and certify that the stated i~formation i~ true and correct to the best of my know/edge <br /> <br /> ; Or'her permits :equired 'b~;ep,:: Pli~i.g ;U ";i;:;ikcsa;; = <br /> <br /> <br />