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appL Reud: <br /> <br />By: <br /> <br /> MARION COUNTY <br />DEPT. OF BUILDING INSPECTION <br /> ~nator Building # 225 <br /> 220 High St.. N.E. 2nd Floor <br /> Salem. Ore, on 97301 <br />R,H, WiTHROW, BLDG. ADMINI~I'RATOR" <br />B88-514;[ -- F:~8~148 <br /> <br /> 4-3.{~-~0 5:00 P.M.- ...... CODE.A-Phone 588-5373 ..... 8:00 A.M. <br />Da~e: <br /> <br />Permit No. F~ ~ <br />By: ~ <br /> <br /> , lvlOl~'ZLE HO{'4~ iWF&~,i:~AMElqT & EI..~RTCA,L OONN~ION~ . <br />Type of Permit: ~ I ax LOt No; ~ <br /> <br />~t No: BIk. No: Sub dy. Lot Size ~.5 AC Corner? <br /> <br />Wa~r Supply: ...... <br />~e Site <br />Disposel:~ZI~ZNG SE~ ~val: <br /> <br /> No. <br />Area of Bldg: 1,4 ~ 70 Storie~: <br /> Roof <br />Basement: Type-' <br />Heating <br />Systeth: ...... <br /> <br />Valuation: .... ~ ,, <br /> <br />Permit Fee:~ 35°00 <br />State Surcharge: 1,. ~ <br />Plans Chk. Fee-' <br /> <br />~eptic Permit Fee; <br /> <br /> BTU:__ / ........... Total Fees: 36.40 <br /> <br />VALI DA~IONS: <br />ZONING SEPTIC~~ PLANS ~ <br /> <br />REMARKS: <br /> <br /> read this app//c~tlon in its entire.fy and c~[fy ~t ~ $~t~ i~f~metion is ~ue ~d coffer to ~e ~t of my k~w/~ge. <br />$'GNATU.E OF APP~ICANT;~ ~~ ,. ~ ~~ ..... <br /> PLEASE NOTE: DriP, ay and sid~alk in~i~s a~ r~uir~ ~Publ;c Works: <br /> Oth~ ~rmits r~uired ~ th;s dept: Plumbi~ ~ El~trical <br /> <br /> <br />