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MARION COUNTY <br /> BUILDING INSPECTION <br />Senator Building · 220 High Street NI~ · Second Floor · Salem, Oregon 97301-3670 <br />Office Hours; 8:00- 4:30 Phone: 588-5147 24 Hour Code. A-Phone: 588-7904 <br /> <br /> APPLICATION FOR EXEMPT STATUS <br /> (FROM THE STRUCTURAL SPECIALTY CODE) <br /> FOR AN AGRICULTURAL BUILDING <br /> <br />PROPOSED LOCATION: ~'~%~$~/~ ~ TAX ACCOUNT= <br />S~CTION: /~-~mSR~P: '~ ~A~u~: . l~ ac~tss: GO <br />Is this property classified as farm deferral by the Marion County <br />Assessor Department? (You must provide a copy of your tax statement <br />showing the farm deferral.) Y ~ N <br /> <br />Are you located within the Urban Growth Boundary? Y N <br /> <br />Describe in detail the use of and/or commodities stored in the proposed <br />structure: ~w~,%~ ~ ~/.~.zF . 6~w) /~ /~,~.~ <br /> <br />4. Is the proposed structure located within a flood plain? Y N ~ <br /> <br />10. <br /> <br />DOeS the proposed structure have any of the following systems? <br />Electrical ?~ Plur~bing __ Heating/Cooling/Ventilation <br />Where wall restroom facilities be provided? <br /> <br />Will persons be working in the structure more than a total of 144 hours, <br />duri~ a~ w~e~ of th~ year? Y N <br /> <br />Explain: <br /> <br />This amplicati~n will not be considered complete without a <br />See attached site plan requirements. <br /> <br />What zs the distance from the proposed structure to prop~%liai~· <br />and/or other structures? Front ~" Left side ~o' <br />Right Side ~' Rear /~ ~r structures' ' -- <br /> <br />I certify that I have read this application and state that the information <br />given is correct. I agree to comply with all state laws and county ordinances <br />relating to building construction. <br /> <br />SIGNATURE <br />DATE <br /> <br />PHONE <br /> <br />OFFICE USE ONLY SITUS NO. <br /> <br />Planning Division validation By: <br /> <br />NAME (Please print) <br /> <br />ST~ET ADDRES~ ' <br /> <br />CITY STATE ~IP <br /> <br />COMMENTS: <br /> <br />7/91 <br /> <br />Building oivi ion validation By, D* E, $- <br /> <br />.... ' ..... ' ..... ' ..... ~'""" .... " s~Ruc~u~i, p~,t.~"iS ~eui--~--~ <br />APPROVED: DENIED: <br /> O~her ~ermita required:E~E~ectrleal~,P]~,~bing, Mechanical, Septic <br /> <br /> <br />