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By: <br /> <br />Type of Permit' <br /> <br />81dr, & No,;--. <br /> <br /> MARION COUNTY <br />DE.~T. OF 6UILDING INSPECTION <br /> <br /> 22D High ~t., N.E. <br /> ~m, O~on 97~1 <br /> <br /> ~141 <br /> <br />~.-1~-- 5:O0 P.M ...................... CODE-A-Phone .................. ~:g0 A.M. Dat~: <br /> <br />Fqafenlt No.: 86-9_6_5 <br /> 9-19-86 <br /> <br />1112~ ~AI']P ~ f:m. <br /> <br />Plans by: ............... ~ <br /> I <br /> <br />Lot No,:__.__-_--J~lk, No.:_~ub, dy: <br />Are~ of ~k~g, 2rKI ~ <br />Main Fir.: ,. Fir,; meat: <br /> <br />To~ <br />Area: <br /> <br />Roof 'Type: True~'Stlok' Height: <br />Heat Ing Woo~t Water <br />~yetem; Rtove: .............. ~Y: ,, <br />~ptlc TeAR Now <br />81~ EviL: ..... <br />System~ ............ Gala.: 1~ <br /> <br />VALIDATIONS: <br />Zoning: MeOllanleaJ: <br /> <br />/ ~ rD ~;~ ac~ing ~ the au~i~ ~ana ~ a~ltoad~ t~ )a~ o~ ~ <br />State of O~g~ e~ t~ ~ of M~ion ~. P~RMIT EXPIRE& IF WORK <br />NO T COMMENCED WITHIN 1~ DA Y~, I iu~her expiry waff~t that I ~p~ with <br />the provl8~na Of OR8 ~1.~ to 701.1~5 ~auae: <br /> <br />( ) The work w/ii be performed <br /> by a registered builder <br />( ) Other (P/ease aaeclf~) <br /> <br />( ) I am performing work on a P~Operty I Own <br /> or occupy <br />[ ) I em · regJ~teM~ Au#der OR ( ) the <br /> auth~ ~p~tati~ of a <br /> ~[ato~ bul~r <br /> <br />Valuation; <br />Bldg. Permit <br />Fee:. (+ $%) ...... <br /> <br />Elect. Fee: <br /> <br />Meoh. Fee: <br /> <br />Plumb. Fee: <br />State <br />Suroha(ge: ~4%) <br /> <br />Plans Chk_ <br />Septl~ TinY, <br />Permit Fee: <br /> <br />DEQ Sumharge: - <br />TOTAL FEE; 6OeOO ........ <br />BLDG, <br />RECEIPT NO: ~ <br />Driveway <br />Permit Fee: <br />Site Plan <br />Review Fee:_ <br />Public Works <br />Re(:elpt No.: <br /> <br />REMARKS:q. <br /> <br />Other I:mrmit~ required by this dept.: Plumbing D ElectriCal I~ Mechanical <br /> <br /> <br />