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MARION COUNTY <br /> BUILDING INSPECTION <br />Senator Building · 220 High Street NE · Second Floor · Salem, Oregon 97301-3670 <br />Office Hours; 8:00 - 4:30 Phone~ $85-~147 24 Hou~' Code-A-phone: ~88-7904 <br /> <br /> APPLICATION FOR EXEMPT STATUS <br /> FROM THE STRUCTURAL SPECIALTY CODE <br />FOR AN AORICULTURAL BUILDING ON A COMMERCIAL FARM <br /> <br />Ig this property classified as farm deferred? Y ~ N <br />(You must provide a computer printout verifying speoial assessment for far~ <br />This can be obtained at the Marion County Assessor's Office looated in the Franklin <br />Building, 495 State Street, salem) <br /> <br />Are you located within the Urban Growth Boundary? Y __ N <br /> <br />Describe, in detail your comm~roial ~arm ~nterprise: ~ ~ <br /> <br />Describe~ detail the use of and/or co~oditie~ ~to~ed in ~he proposed structure: <br /> <br />Is th~ propo~d st~uutut~ located within a flood plain? Y __ N ~-' <br /> <br />DO~S the p~opos~ ~t~uotu~e have any of the following systems? <br />Electrical Y / N Plumbing Y /N ~eating/Cooling/Ventilation Y / N__ <br /> <br />Wher~ will festroom facilities be provided? <br /> / <br />Will persons be working in the str~e ~ore than a total of 144 hours, du~in~ any <br />week off the year? Y N <br /> <br />is this structure used by the public at any time? Y N <br />Explain: <br /> <br />10. What is the distance from the proposed structure to property lines and/or othe~ <br /> structures? Front Rear <br /> Left Side Right Side Other Structures <br /> <br />11. Thi~ application will not be considered complete without a site plan. see attached <br /> site plan requirements. <br /> <br /> certify that I have read this application and state that the information given is <br />correct. I agree to comply with all state laws and county ordinances relatlng to building <br /> <br />OFFICE USE ONLy SITUS NO. ZONE= MAP: <br />PIJ%NNING DIVISION: <br /> Validated By: Approved: Denied: Date: <br /> <br />¢OMNENTS: <br /> <br /> BUILDING DIVISION-' V/ <br /> <br /> APPROVED: DENIED: STRUC'~/RA.L PERMIT IS REQUIRED <br /> Other permits required: Electrical, pl,,~hing, Mechanical, septic <br />MC 15-76 <br />REV 9/93 <br /> <br /> <br />