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,, AppL Rev<J: <br /> <br />Date: <br /> <br /> MARION COUNTY <br />DEPT, OF BUILDING INSPECTION. <br />~enator Buildillg ~ 225 <br />~20 High St., N.E. 2nd FIoo~ <br /> Salem, Oregon 97301 <br /> <br /> 6855147 - 58~S148 <br />5:00 P.M.- .......... CODE-A.Phone 588-5373 ........... 8:043 A,I~, <br /> <br />Typ~ of Permit: <br /> <br /> 8185 Anderson Road~ S. ~. <br />Address: .... <br /> <br />Owner: ,,.,~ ,;~.r Jo,~'~%O~',D ~; p~ne: <br /> <br />; ~va,Lu,~t zon <br /> AU~asville <br /> P~ccel #5 <br /> <br />Plans by; J~hon~: Address: <br /> ~:~ '? .,. ~., ,' , <br /> <br />Lot No: ,, .~ BIk. No: Subdv. · <br /> <br />.... LOt Size ~2~ 66 Aore~ero~c? no <br /> <br />Water Supply: Valuation: ~ <br />Sewage Site <br />Disposal: ~ Eval-' Permit Fee:- <br /> N~, <br />Area of Bldg: Storie~: State Surcharge: <br /> Roof <br />Basement: YyPe: Plans Chk. Fee: <br /> <br />Heating <br />System; Septic Permit Fee: <br /> <br />120.00 <br /> <br />i5.00 <br /> <br />BTU: ...... Total Fees: 1'!)5.00 ,, <br /> <br />/ .~ ~ bu//~ ~/~ to the ~bmi~ ~ns ~nd ~if/cat~n~, ~e la~ of ~e Sm~ of Oran and ~ <br />C~nw- Perm/t ex~es if ~rk no~ comme~ within I~ days. I furh~ expf~y warra~t ~et J ~ply wi~ ~ pro~i~o~ of ORS <br />701.~5 to 701,125 <br />{ ] / am a ~i=ter~ builder ~ ( J ~e ~oriz~ r~re~n~tJve of a r~i~ build~ <br />( J The ~rk w/II be pefform~ by a r~i~e~ build~ NO~: ~ ~ ~ ~t or ~ <br /> <br />REMARKS: , , ~e ~ ~ ~ <br /> <br />I have read zhis application in its entire~y ar~l certify that the stated information J$ ~rue and correct ~o the bes~ of l'~y ~f~ow/edge, <br /> <br />SIGNATURE OF APPLICANT:~~ ~ <br /> PLEASE NOTE: Drlvewayi~nd sidewalk inspections are required by Public Works: <br /> O~her permits required by this de~t: Plumbing [] Electrical <br /> <br /> <br />