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Appl Becd <br /> <br />~y: D~ttte <br /> <br /> MARION COUNTY <br />DEPT. OF BUILDING INSPECTION <br />·enator Building #225 <br />220 High St.. N.E. 2nd Floor <br /> Salem, Oregon g7301 <br /> <br />588~5147 -- 586-5148 <br /> <br />Date <br /> <br />Type of Permit. MDb'Lie home r eplaoement <br /> <br /> 7263 Sha~ E~,. A~laSV~l-].e <br />~dress. ,, <br /> <br />Owner, ,,,,,~,e~e ~eho Phone <br /> <br />Permit No, 8~463,~ <br /> <br />By:..._~__ <br /> <br />5:00 P.M ...................... CODE-A-Phone .................... 800 A.M. DaJLe; 9-12-84 <br /> <br /> Tax Lot No.: 57788-000 <br /> <br />Sec.. ;>5 Twnshp,; 8 .,, ,Roe; <br /> <br /> 7323 $~/ H~Y SE <br />Address: <br /> <br />IBIdr. & NO, DO.iD R. COSTA, ~l~one: <br /> <br />Address: <br /> <br />Plans by' , ....... Phone: Address ........ <br /> <br />Lot NO,: <br />Area of Bldg. 2nS <br />Main Fir,:. Fir. <br /> <br />RIk No Sub. dy-: Lot $i~e:/i- ~cres Corner?, ~O <br /> <br /> Base- Total <br />..... .ment:~rea: /4'~"~'*"*"*"*"*~ <br /> <br />Roof Type: ....... Truss/Stlok: , ,Height:, <br />Hosting Wood Water <br />System. Stove : RUpply: <br />Septic Tank New <br />Site Eval,- ~nstal. <br />Exist. NO <br />System Gale.: ~, , <br /> <br />YALIDAIION$: <br />Z°nle~'~'~t~ ~. ~,')-.~,,"~,AL Mechanical: <br />Date ~,~.'~a ~:f~DI' mate: <br /> <br />Date f~ ~ [~ u ~ mate: <br /> <br />I agree to build aooording to the submitted plans and .~pealfteetions, the laws of the <br />State of Oregon end the Ordinances of Merioit County. PERMIT EXPIRES IF WORK <br />NO T COMMENCED WI THIN 180 DA Y$, I further expressly warrant that I comply with <br /> <br />Valuation <br />Bldg, Permit <br />Fee, (+ 5%) <br /> <br />Elect. Fee: hiri~ elec. <br /> <br />Meoh. Fee <br /> <br />Plumb_ Fee, <br />State <br />Sumharge,.,,.,,14%) 2.OO <br /> <br />Plans Chk Fee: <br />Septic Tank <br />Permit Fee; 60.00 <br /> <br />DEQ Sureharge, <br /> <br />TOTAL FEE. 'i 19"~O <br /> <br />the provisions of ORS 701.005 to 701.12~ because: <br /> <br />I am performing work on a property I own <br />or Occupy <br />I am · registered butlcler OR ( ~ the <br />authorized representative of a <br />registered builder <br /> <br />?he wOH~ will be performed <br />bY a registered builder <br />Other (please specify) <br /> <br />BLDG_ ~_..) / ~) <br />RECEIPT NO.= <br />Driveway <br />Permit Fee: <br />Site Plac <br />Review Fee: ... <br />Public Works <br />Receipt No <br /> <br />REMARKS: <br /> <br />I have read this application lit its entirety and certify that the stated Iitformation is true and correct to the best of my know/edge <br /> <br />SIGNATURE OF APPLICANT: ....... <br /> PLEASE NOTE: Driveway and sidewalk inspection ate required by Publig WOrkS: 588-5036 <br /> <br /> <br />