Laserfiche WebLink
..= ,~. r~ ti %r/ DEP B~.~°DING INSPECTION <br />Address: <br /> <br />No,: <br /> <br />Permit No.: <br /> <br />By;_. <br /> <br />, Phone. Address: <br /> <br /> 1' ........ ' ' ~" ' ~ Is~trm~. ~ Min Peel. Froat Slde~ Rear <br /> <br />. [v u <br /> <br />Lot NO-: .... Rlk. No,' Rub, dy.;. ~ ...... Lot Sloe: I~ ~ I ~Comer? ~ <br />Area of B~dg. 2nd Ba~ Total <br />Main Fir.: Fir.: ment:, Ama: VaJuatJon: <br /> Bldg. Permit <br />Root Ty~ , Truss/Stick: _ Height~ ....... ; F~: (+ 5%) .... <br /> <br />Heating <br />System; <br />Septic Tank <br />Site EvaL: <br />Exist. <br />System: <br /> <br />Wood <br />Stove: . <br /> <br />VALIOATiON$: <br /> <br />Zoning: / i <br />Date: l/ ! I~ate: <br />Septic Ta4:,,,~ // / ~'0".,.. A~fr',] Plans: <br /> <br />I agree to build a~cOrding to ~he ~ubmOted plan~ ~d op~ification~, tho/awe of the <br />State of Oregon a~d the Ordinanc~ of Marign County. PERMI~ EXPlRE~ IF WORK <br />NO T COMMENCED WI THIN 180 DA YS. i further exp~ssly warrant that i comply with <br />~he p/oviaione of OR~ 701.0~ to 701,125 b~ause: <br /> <br />( ) I am ~rforming work on a property I own <br /> or o~cupy <br />( ) I am a ~egietered builder OR ( ) the <br /> authorized representative of a <br /> registered builder <br /> <br />Water ., . ~,~?,o-~ ~ <br />Rupply: <br /> <br /> . ...... <br /> <br /> ......... *~>' *--'~'~ ~ ~,~; ....... <br /> <br /> Septic Teak <br /> Permit Fee: <br /> <br />The work will be performed <br />by e registered builder <br />Other (please specify) <br /> <br />DEQ Sur_~harge: <br />e..~ t= e r~ <br />TOTAL FEE: <br />BLDG. <br />RECEIPT NO~: <br />Driveway <br />Permit Fee: <br />Site Plan <br />Review Fee: _ <br />Public Works <br />Reoeipt No.: <br /> <br />I ,~0. oD <br /> <br />I have read thia applioation in its entirety anc~certify that thawed information ts true and correot to the best o! my <br /> <br />knowledge. <br /> <br /> <br />