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TUESDAY <br />App{. Recd,: <br /> <br /> PATTY <br />By: <br /> <br /> 4-9-85 <br />Oate; <br /> <br /> MARION COUNTY <br /> DEPT. OF BUILDING INSPECTION <br /> Senator Building ¢225 /_//¢,~--- <br /> 220 High St., N.E, 2nd Floor Permit No <br /> Salem, Oregon 97301 <br /> <br /> 588-5147 -- 588-5148 <br />5:00 P,M ....................... CODE-A-Phone ...................... 8:00 A.M. <br /> Date: <br /> <br /> REMODEL VA REVIEW 3rd SET OF PLANS <br />Type of Permit: , Tax Lot No,:__, <br /> <br /> 200 SANTI~ AVE DET~IT <br />Addreaa: Sec.: ,, Twnshp.: Pge,', <br /> <br /> JOHN PFAFF 838-1854 20 SOUTH FOURTH INDEPEWDENCE <br />Owner: .... Phone:_, Address: 9~1 <br /> <br />Bldr, & No · Phone: Address:_ <br />Plans by: Phone:__ Address; <br /> <br /> MapPage } Z~r~e Zone Chenge Part. Cond, Use I Variance/Ad J,I FT/FD Occupancy Type of Coest. <br /> <br /> or Ccc. Ld,'. Min Req. [ <br />Use of Sldg.: '~o. edrn',s, Setbacks: Front Sides Rea~__ <br /> <br />Lot NO.: .... BIk. N o,; --I I Sub. dY'' Lot Size: Corner? ..... <br /> <br />Area of Bldg. 2nd Base~ Total <br /> <br />Main Fir.: __ Fir,: merit:_ A(e~t: valuation:__ <br /> Bldg. Permit <br />Roof Type:__ _ Truss/Stick:__ Height' Fee: (* 5%) <br />Heating Wood Water <br />System: ,,, Stove: .Supply: Elect, Fee: <br />Septic Tank New <br />Site Eval.: _instal.: Mech, Fee:_ , <br />Exlst, NO, <br />System:. Gals.: Plumb, Fee:_~ <br /> State <br />VALIgATfONS: Surcharge: (4%) <br />Zoning: Mechanical: <br />Cate: .... Date:_ Plans Chk, Fee: .... <br />Septic Tank: Plans: Septic Tank <br /> <br />Date: ..... Date: '~'-~¢''- ~'~¢~- ~ Permit Fee: <br /> <br />I agree to build according to the submitted plans and specifications, the laws of the <br />State of Oregon and the Ordinances of Marion Cour~ty. PERMIT EXPIRES IF WORK <br />NO T COMMENCED WI THIN 180 DA YS. I further expresaly warrant that I comply with <br />tile provisions of ORS 701.005 to 701,125 because: <br /> <br />DEQ Surcharge: <br /> <br />TOTAL FEE; <br />BLDG, <br /> <br />( ) Iarn performing work on a property I own <br /> or occupy <br />( ) I am e registered builder Ot~ ( ) the <br /> authorized represet?tative of a <br /> registered builder <br /> <br /> RECEIPT NO,: <br />( ) The work will be performed Driveway <br />by a registered builder Permit Fee: _ <br />( ) Other (please specity) Site Plan <br /> Review Fee:__,, <br /> Public Works <br /> Receipt NO,; <br /> <br />10o00 <br /> <br />10.00 <br /> <br />3532 <br /> <br />REMARKS:. <br /> <br />SIGNATURE OF APPLICANT: '///A~ ~ '' f F ' " <br /> PLEASE NOTE: Orive~ay and sidewa/'f/k inspection are required by Public Works: 588-5036 <br /> Other permita required by this dept.: Plumbing E~ Electrical El Mechanical E3 <br /> <br /> <br />