Laserfiche WebLink
lo-2q-B6 <br />Date: <br /> <br /> MARION COUNTY <br /> DEPT. OF BUILDING INSPECTION <br /> Senator Building #225 <br /> 220 Hist1 St., N.E. 2nd Floor <br /> Salem, Oregon 97301 <br /> <br /> S88-$147 -- $88-8148 <br />5:00 P-M ...................... .CODE-A-Phone ...................... 8:00 A,M, <br /> <br />Permit No.; <br /> <br />By:, <br />Date: /~ <br /> <br />Sldr. & No.' ..... <br /> <br />~ E~VA~ION$ <br /> ~ Phone: <br /> <br />.Tax Lot <br /> <br />Address: same <br /> <br />~ddre~: ~ ~ <br /> <br />Lot No.: _BIk. NO.: __, , Sub. dy.:__ ~ <br /> <br />Area of Bldg, 3nd Base- Total <br />Main Fir,: Fir.: ~ent: , Am~:_ <br /> <br />.... Lot Size:~lO A~ <br /> <br />Roof Type: Tr uss/Stiek:.~.,------Helg ht:~ <br />Heating Wood Water <br />System: .... Stove:r ,J~upply: ~' <br />Septic Tank New <br />Site Eval.: ~lnstal,: <br />Exist. NO. <br />System: _~ ~_ . ,,.Gals.: '100~ ..~aAl~,u~ <br /> <br />VALIDATIONS: <br />Zoning: ~ Mechanical: <br />Oate:__ //I ~ ~ ~Oate; <br /> <br />Date: :/~v~ /V ~ -n~ate: ....... <br /> <br />I agree to build according to the su~itted plane and s~ificatlons, the laws of the <br />~tam of Orego~ end the OrdinanCes of Marion County. PERMIT EXPIRES IF WORK <br />NOT COMMENCED WITHIN 180 DA YS. I further expressly warrant t~a~ I comply with <br />the provisions Of ORS 701,0~ to ~01,1~5 because: <br /> <br />I am performing work on a property I own <br />or occupy <br />I em a registered builder OR ( ) the <br />authorized representative of a <br />registered builder <br /> <br />( } The work will be performed <br /> by a registered builder <br />( ) Other (please specify) <br /> <br />Corner?_~lO .. <br /> <br />Valuation: <br />Bldg, Permit <br />Fee: (~- 5%) <br /> <br />Elect. Fee; <br /> <br />Mech. Fee~ <br /> <br />Plumb. Fee; <br />State <br />Surcharge: (4%) <br /> <br />Plans Ohk. Fee: ..... <br />Septic Tank , <br />Permit Fee: <br /> <br />OEO Surcharge: <br /> <br />TOTAL FEE: ~ <br /> <br />RECEIPT NO.; <br />Driveway <br />Permit Fee: ............ <br />Site Plan <br />Review Fee: <br />Public Works <br />Reoeipt NO,: __ <br /> <br />REMARKS: <br /> <br />Other luired by this dept.: Plumbing r'3 Electrical ~ Mechanical <br /> <br /> <br />