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Appl. Revd: WC d '~°s rk~- <br />By: dm <br /> <br />Date: [1 'L /Z /78 <br /> <br /> MARION COUNTY <br /> DEPT. OF BUILDING INSPECTION <br /> Downtown Senator Building <br /> 220 High St., N.E. 2nd Floor <br /> Salem, Oregon 97301 <br />R.H. WITHROW, BLDG. ADMINISTRATOR <br />588-5147 -- 588-5148 <br /> <br />Type of Permit: Add~ n,:f R~,;~dcnc¢ '[;o e×is't:in~ ~' " n <br /> · ~fd~-~,~_~ ,',oO~ Tax Lot No; <br /> <br />Address: i~otrbe ~ ~o~ ~/+~ * *11%0~ ~ ~ Sec.~. <br /> <br />Owner: ~o~ ~enz~sO~ Phone: ~78-~959 Address: S::~e <br /> <br />Permit No. <br /> <br />By: <br /> <br />Date; <br /> <br />Twnshp. ~ <br /> <br />Bldr. & No,: Self Phone: __ Address: <br /> <br />Plans by: James G,aZ~vood Phone: 981-5720 <br /> Map~.~Page 7~}~/ [ ZOne Chg. [ Part. Cond. Use Variance <br /> <br />.... ~ bed~oom dwel]_i~ <br /> <br />Min ReQ. <br />Setbacks: <br /> <br />Lot No; BIk, NO: Sub dv. <br /> <br />Water Supply: ~,~,,~.A Valuation: <br />Sewage --~ Feas. <br />Disposah g ¢'l'~'~J~ ..... Study: Permit Fee: <br /> No. <br />Area of Bldg; '~8 x56 .,, Stories:1 State Surcharge: <br /> 1~l+0 Sci f%., Roof <br />Basement: z'lO Type; Comp - ~;~q],~.s Plans Chk. Fee: <br />Heating <br />System: ii'cz'cc:el .lip ~;%oc & Wood Septic Permit Fee: <br /> <br />Lot Size 100.150 <br /> <br /> 8%00 <br /> <br />Corner? <br /> <br />BTU: Total Fees: <br /> <br /> Rcpt, NO: <br /> / <br />I agree to bul/d eccord/ng to the submitted plans/~ spec/f/cations, the la~ of the State of O~b aq~ the Qldina~ cf Mar/on <br /> <br />ZONIN~ SEPTIC PLANS c, ,, <br />By: ~/~ By: ~ ,/~ <br /> <br />PLEASE NOTE: Driveway and sidewalk inspections are required by Public Works; E;88-5036 <br />Other permits required by this dept; Plumbing ~ectrical [~'¢~-' ~. <br /> <br /> <br />