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Appl. R~evd; ' ~"tte$~L.~. <br /> <br /> MARION COUNTY <br /> DEPT. OF BUILDING INSPECTION <br /> Senator Building # 2~5 <br /> 220 High St., N.E. 2.nd Floor <br /> Salem, O?egon 97301 <br />R,H. WiTHROW. BLDG. ADMINISTRATOR <br />588.5~47 - 588-5148 <br /> <br />Owner; Tom Z,,~ i- <br /> <br />SIdr. ~ No.: ...... <br /> <br />Tax LoX No: hO6;~-OOO <br /> <br />Plans by; <br /> <br />U~ of 81dg.,~ <br /> <br />Phone: .. ~ Address: ..... <br /> <br /> Phone: Addre~: <br /> Cond,, U~ ' Va¢iance .......... <br /> <br />~,~?, 0¢¢. bd~ . ISetb~ack~: <br /> <br />Lo[ No: BIk. No; ~, ~ub du. <br /> <br />Lot Size i_C~_ x 16~ COrner? <br /> <br />Water Supply:, G~ ~? Valuation:: <br /> <br />Sewage Site <br />Disposal; ~*~+ ~ ~- Evah Permit Fee: <br /> No, <br />Area of l~lldg; Stories: State Surcharge; ~ <br /> Roof <br />J~a~ern~n~; ~.. Type:., Plans Chk. Fee: <br />Heatmg <br />System; ......... Septic Permit Fee; <br /> <br />BTU: __ <br /> <br />Total Fees; <br />Rcpc. No: <br /> <br />I agree to bul/d ~ccordin~ to ~e submitted p/anZ and ~l~cificat;o~% ~1~ law~ af the ~tare of Or~olt ~v~d th~ Ol~llflat~'~ of Merio~ <br />County. Permit expires if work not comme~d within ,2~ ; <br />VALIDATIONS; / ....... <br /> <br />PLEASE NOTE: Driveway and sldew~lk inspections are required by Public Works: 588-5036 <br />Oth~ t3~rm{ts mqulred by this dept: Pl~mbihta ~ Electrical [] <br /> <br /> <br />