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Appi. Recd: <br /> ~e <br /> <br /> MARION COUNTY <br /> DEPT. OI~ BUILDING INSPECTION <br /> Senator Rulldtng #225 <br /> 220 High St., N.E. 2~d F[OO¢ <br /> SaJem, Oregon 97301 <br /> <br /> ~.5t47 -- 588-5148 <br />5:00 P.M., ..................... CODE-A-Phone ...................... 8',00 A.M. <br /> <br /> F~bile hc~e, Sept;b= T~ <br />Type of Permit ...... <br /> 12343 M~. ~el ~s ~a~, N~. n <br />Address: (~ : <br /> ~ G~ ~' 8~5~871 <br />O~ef: Phone: <br /> <br />81dr, & NO.: Phone: <br /> <br />Permit No,:, <br /> <br />Tote} <br /> <br /> By' : Pal-r-)j, <br /> <br /> Date: ..'///~/'-,/'/ ..~,a"-,O. <br /> <br /> 3?65-000 <br /> , .Tax Lot No.: <br /> <br /> 4 6 ~ 1W <br />Sec,: Twnshp.: Rge,: <br /> <br /> 3~0 ~ay~et, ~t. ~gel <br />Address; ,~/~ ~ [. ~--~ ~ [ <br /> <br />Ptans by:.~._ Phone; : Address: ...... <br /> <br /> '" (~u~"'"h~ ~i~ ~ 4 <br />LOt No.: ~lk No ........ Su~- dy.: ,,, Iot Size: 5 ~ Corner? <br />Area of Bldg, 2nd Base- <br />MAi~ Fir.; Fir.: ., merit: <br /> <br />Height:, <br /> <br />Roof TyDe~ Truss/Stick',,, <br />Heating WooO <br />System: ,,, Stove: <br />Septic Tank 79-726 New <br />Site Eval,: <br />Exist. No. <br />System: ....... Gals.; <br /> <br />Valuatiom <br />Bldg. Permit 35 <br />Fee: (+ 5%) 1 _ 75 <br /> <br />Water <br />Supply: Elect. Fee: hi~in,g elec, <br /> <br />VALIOA~IONS: ~ <br /> <br />I agr~ to build accofdi~ to thp submiffed plan~ a~d s~ificatlo~, the law$ of the <br />~fafe of O~on end the Ordinances Of Marion Count, PERMIT EXPIRES IF WORK <br />NO T COMMENCED WItHiN 180 DA Y~. I fU~her exp~ly warrant that I comply with <br />the provision$ of OR~ 707.00~ ~0 701.125 because: <br /> <br />The work will be performed <br />by a registered butl(Yer <br />Other (please specify) <br /> <br />I am performing work on a property I own <br />or occupy <br />{ am a mglsmred builder OR ( ) the <br />guthorized ~epreaenteHve of a <br />registered builder <br /> <br />Mech, Fee: <br /> <br />Plumb. Fee: ...... <br />State <br />Surcharge:, (4%) <br /> <br />Plans Chk, Fee: <br />Septic Tank <br />Permit Fee: 7.5.00 <br /> <br />OEO Surcharge: <br /> <br />TOTAL PEE: <br />BLOG, <br />RECEIPT NO,: .... <br />Driveway <br />Permit Fee: <br />Site Plan <br />Review Fee: <br />Public Works <br />Receipt No.: <br /> <br />5.00 <br /> <br />118.13 <br /> <br /> <br />