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Appl. Revd: ,L.D.~ , . <br /> <br />By: 0'.' [~ t ~L <br /> <br />Date: 12-5-79 <br /> <br /> MARION COUNTY <br /> DEPT, OF BUILDING INSPECTION <br /> Senator Building # 225 <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 />By; <br />Date,-?--?.? <br /> <br />Type of Permit: <br /> <br />Address:_ ~ <br /> <br />Owner: __ <br /> <br />81dr. & No.: <br /> <br /> MOBILE Jf-)['L,'.; .a~i L~.~CE~N .... Tax Lot No; <br />13751 LI.,;::U;!iz~ DR ? .?;. AURO~'~ ec ........ Twpshp ...... <br /> <br /> 0"d",2/';~J AZdtAN Phone: 678-5030 , Address: <br /> <br /> Phone: Address: <br /> <br />Plans by: Phone: Address: <br />Map Page Zo~ Zone Chg, Part. Cond. Use Variance Fire ~0ne <br /> <br /> EST.::T:::;S <br />Lot NO: .. ~¢-.~ BIk. NO: ~ Sub dy. <br /> <br />Water SuppLy: 'i] [!]%'f, Valuation: <br />Sewage Site <br />D~sposa ;,,X=, ~,,,. ....... ;,,.TIC Evah Permit Fee:~ <br /> No. <br />Area of Bldg; .,2Z~ ~ 60 Stories: State Surcharge: <br /> Roof <br />Basement; Type; Plans Chk, Fee; <br />Heating <br />System: Septic Permit Fee: <br /> <br />Rge. __ <br /> <br />,J Occupancy Type of Const, -- <br />Front Z* ] <br /> <br />5o .,po <br /> <br /> ~oo <br /> <br />BTU: Total Fees: <br /> <br />I.agree to build ~c¢ord/n9 to the $obmittad plans and spec/f/cations, th~ /aw~ of the State of Oregon ~nd the Ordinances of Marion <br />County. Permit expires if work not com~nced~/th/n~ 120 d¢~. ~ /] <br />SIGNATUR~ OF APPLICANT:~ // ~ ~ <br />....... ~ ~ - / %~~ ~ , ....... <br />VALIDATIONS: ~ ~ <br /> <br /> REMARKS <br /> If dolnsbusfness as described under OP~ 701.055[ I expressly ~arr~n~ that I am a <br />e§istered builder pursuant to the above Statute. <br /> <br />PLEASE NOTE: Driveway and sidewalk inspections are required by Public Works: 588-5036 <br />Other permits required by this dept: Plumbing [~] Electrical I"l <br /> <br /> <br />