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MARION COUNTY <br /> DEPT. OF BUILDING INSPECTION <br /> Senator Eiuilding <br /> 220 High St., N,E, 2nd Floor <br /> Salem, Oregon 97301 <br /> <br /> 688,5147 - 588-5148 <br />P,M,- ........... CODE-A-Phone 588-5375 ........... 8:00 A,M. <br /> <br />Permit No. , ~45 <br />By; Dottle <br /> <br />Date: 4/9/85 <br /> <br />Bldr, & No.: <br />Plans by: <br /> <br />Map Page Zocle <br />Use of B Idg,: <br /> <br />FF <br /> <br />Zone Chg. <br /> <br />Area of Bldg. 2nd <br />Main Fir,:,. Fir.: <br /> <br /> Phone:.,, <br /> <br /> Phone: <br /> <br />oNroO~dd ~ ~1.; Min Rm, <br /> <br />~ Sec. Twnshp. ~Rge. <br /> Address: <br /> Address:_ <br /> <br />Address: <br /> <br />Bose- Total <br /> ,, Area, <br /> <br />Roof Type: <br />Heating Wood <br />System: .... Stove: , <br />Septic Tank New <br />Site Eval, _ ..... Instal - <br />Exist. No. <br />System~ ~3Js,: <br /> <br />VALIDATIONS: <br />Zoning: <br />Dote: ....... <br />Septic Tank: <br />Date: <br /> <br />Fire Zone <br /> <br />J. Occupancy J Type of Const <br /> <br /> Lot sizdb' / Cor,er _/J <br /> <br />Valuofiom <br /> <br />Truss/Stick~ ...... <br /> Water <br /> __ Supply:, <br /> <br />Mechanical: <br />___Date: ..... <br />Plans: .... ~'/~'~'~- <br />__Date:~Z'/~'~_~-- <br /> <br />Elect, Eeer ......... <br /> <br />State <br />Surcharge: ,,, ~' ~ ~ <br /> <br />Plans Chk, Fee, <br />~eptic Tank <br />Permit <br /> <br />I agree to build according to the submitted plans and specifications, the laws of the State <br />of Oregon and the Ordinances of Marion County. Permit expires if Work not commenced <br />within 180 days. I further expressly warrant that I comply with tho provisions of ORS <br />701,005 to 70 I, 125 because: <br />(~'~) I am performing work an o property I OWn Or Occupy <br />( <br /> <br />TOTAL FEE: <~'~ ~' ~*~' <~F__ <br /> <br />) I am a registered builder OR ( ) the authorized <br /> representative of o registered builder <br /> <br /> RECEIPT NO, <br />The work will be performed by a registered builder <br />Other ~'pleose specify) <br /> <br />PLEASE NOTE: ~riveway and siI ',walk/ns~,ction~;~req~uir"ed' b'~ Public W <br /> Other permit~ required by this dept: Plumbing [] EJectrlcal <br /> <br /> <br />