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Chris <br /> <br /> MARION COUNTY <br /> DEPT. OF BUILDING INSPECTION <br /> Senator Building #225 86-522 <br /> 220 High St,, N,E. 2nd Floor Permit ~NL~c' ~3030 <br /> Salem, OregOn 97301 <br /> <br /> 588-5147 -- 588-5148 <br /> <br />Oat¢ 6-3-S6 5;00 P-M ...................... CODE-A-Phone ..................... 8:00 A,M,, <br /> Oaie: 6-12-g6 <br /> <br /> Septic Ade~uacy <br />Type of Permit .. Mobile ~ome Pla¢~ent (Har~ip EQ~. & Tax Lot No.: <br /> <br />Address: 9367 ShOddy Dr. SE <br /> <br /> Donald Woolsey 769-3553 <br />Owner: Phone; <br /> <br />81dr. & NO Phone:; __ <br /> <br />, . Sec-: ~ Twnsl~p :: ~ Rge.: <br />Address;: sa~e <br /> <br />Plans by::. <br /> <br />Use of Bids <br /> <br />,Phone: Address:: ~,, <br />or Ccc. Ld ~ , ~t~cks ~ ~ ~ O <br /> <br />Lot No.: RIk NO, SUb, dy, <br />Area Ot Bids 9nd Base- <br />Ma{n Fir, Fir.' ...... ment; .... <br /> <br />Root Type: ................. Truss/Stick: <br />Heating Wood Water <br />System: Stove: .Supply: well <br />Septic Tan k New <br />Site Eval,; Instal.: <br />Ex,st,, No <br />System; yes Gals_: ?' <br /> <br />VALIDATIONS; <br />Zoning; ~ Mechanical: <br />O a t a :: ~ ~/*~ - g'/"_'_'_'-,~l~"~_'~-~'~'!~;'t'"'-~ mate: <br />SepticTank ~ // ./'- / _ -- .'% .~-~ Plans: /"/~,~'~. __ <br /> <br />~ agree to bu;Id according to tl~e ~ut:mitted pl~en¢l *p~tficatlon$, tile laws o! tile <br />Stats of Oregon and the Ordinances o/Marion County. PERMIT EXPIRES IF WORK <br />NO ? C O MMEN CEO Wi THIN t eO 0,4 YS I further expressly warrant that I comply w~th <br />the provis~ons of ORS 701.005 to 701 125 because: <br /> <br />I am performing work on a property I ow~ <br />or occupy <br />t am a registered builder OR I ) the <br />authorized representative of a <br />registered builder <br /> <br /> I et Size,,,,,, 1 ac Comer? <br />Total <br />Area: si~,~? Valuation::~0.0 <br /> B~dg. Permit/ <br />_.Height: .... Fee (+5%) <br /> <br /> Elect_ Fee:.__40'00 <br /> Mech Fee:, <br /> <br /> Plumb, Fee:: <br /> State <br /> Surcharge, <br /> Fleet Surcharge, 7,68 <br /> Plans Chk. Fee: <br /> <br />( ) The work will be performed <br /> by a registered builder <br />( ) Other (please spe(;Ify) <br /> <br />Septic Tank <br />Permit Fee;; 60,00 <br /> <br />DEQ Surcharge: 5.00 <br />TOTAL FEE: 152.43 <br /> <br />O,,veway <br />Permi~ Fee~ ~__ <br />Site Plan ~ <br />Review Fee; <br />PUbliC Works <br />Receipt NO.: <br /> <br />t have ~'ead thio app#~at~on in its entirety and ced/fy that the stated information is true end correct to the beat of my knowledge. <br /> <br /> Other ~rmi~ required by this dept-; Plumbing B ~lectrical ~ Mechanical B <br /> <br /> <br />