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BUILDING INSPECTION <br />3150 LANCASTER DR NE- SUITE C <br />__ SALEM OREGON 97305 503-588-5147 <br /> <br />-ocigq <br /> <br />APPLICATION FOR EXEMPT STATUS FROM THE STRUCTURAL SPECIALITY CODE <br /> <br /> FOR AN AGRICULTURAL BUILDING ON A COMMERCIAL FARM <br /> <br />PROPOSED LOC^T,ON.' <br /> <br />BUILDING SITE ACRES: ~9 <br /> <br />TOTAl# OE ACRES EARMED: ~¢ Z~ <br /> <br />1. Is this property classified by the Assessor as farm deferred? <br />2. Are you located within the Urban Growth Boundary? <br /> <br />Y <br /> <br />3. BE SPECIFI~C in describing your commercial farm~ enterprise, size of operation, and annual profit.-'.l[~, <br /> provide proof of farm income for the last three (3) years. ~ <br /> <br />4l BE SPECIFIC in describing thp u,?e of and/or commodities that will be stored in the proposed structure: <br /> <br />5. What is lhe size of the proposed building? LENGTH~:~_ WIDTH °o~"' HEIGHT_~_~ AREA <br /> <br />6. is the proposed structure located within a flood plain.~ Y N <br /> <br /> Will the proposed structure have any of the following systems? If yes- separate permits are required. <br /> Electrical Y_~ N__ Plumbing Y N~:X~ Heating/Cooling/Ventilation Y~__ N~Septic Y ___ N~:~_ <br />8. Where will restroom facilities be provided? '-'"~'0 <br /> <br />9. What is the maximum number of people present in the building at any one time during the year.~ <br /> <br />10. Is this structure used by the public at any time? Y NZ <br /> Explain <br /> <br />11. What is the distance from the proposed structure to property lines and/or other structures? <br /> Front J~,+ Rear Z~.~0 -f Left side~~' Right side~..~:~ ~ Other <br /> <br />12. This application will not be considered complete without a site plan that includes the size of the building. <br /> **See attached site plan requirements. <br /> <br />I certify that h~ <br />a~ <br /> <br />~d this application and state that the information given is correct. I agree to comply with <br />nces relating to building construction. <br /> <br /> STREET ADDRESS <br /> <br />PHONE <br /> <br />CITY STATE/ZIP CODE <br /> <br />MC15-76-REV 7/97 FOR OFFICE USE ONLY <br />APPROVED DENIED DATE <br /> <br /> <br />