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DWELLING APPLICATION <br />DATE/TIME 06/15/99 10:58 <br />TYPE New Single Family Dwelling <br />OCCUPANCY R-3 <br />CONST TYPE V-N <br />UGB: SITE: FD <br /> <br />ACTIVITY NO <br />STATUS <br />APPLIED <br />TO EXPIRE <br /> <br />99 04654 <br />APPLIED <br />06/15/1999 <br />12/12/1999 <br /> <br />WORK DESC <br />SITE ADDRESS <br /> <br />SUBDIVISION <br />TAX ACCOUNT <br />PARCEL SIZE <br /> <br />APPLICANT <br />ADDRESS <br /> <br />PHONE <br />TOTAL SQ FEET <br /> <br /> VALUATION <br /> <br />: NSPD- 3 BEDRMS REPLACEMENT FOR SPU LUCATOR: 042W2b guiDO <br />: CITY: MARION COUNTY <br />19487 CASE RD NE AR <br /> <br /> LOT: BL: <br /> 41878-000 MAP: 9 ZONE: EFU LAND USE: <br /> 4,72 <br /> <br />BURNHAM DENNIS OWNER : BURNHAM,DENNIS A & ELENA <br />19517 CASE RD NE PHONE: <br />AURORA OR 97002 CONTR : <br /> PHONE: <br />678-1847 OCCB: <br /> <br />3,029 1ST FLR: 1736 2ND FLR: 591 3RD FLR: <br /> GARAGE: 702 BASEMENT: OTHER: <br />161.885,36 STORIES: 2 HEIGHT: <br /> <br />25 <br /> <br />Units Description Fee <br /> 1.0 Residential building fee 560.37 <br /> 1.0 Plan review fee 363.48 <br /> 1 Residential plumbing fee 272.61 <br /> 1 Residential mechanical fee 121.16 <br /> 1 Residential electrical fee 272.61 <br /> 1 State surcharge 61.34 <br /> 1 Zone surcharge 30.00 <br /> <br /> Assessed fees 1,871.57 <br /> Adjustments -190.00 <br /> Total fees 1,681.57 <br /> PAYEE: Total payments: 1.681.57 <br /> Balance due : .00 <br /> <br /> THIS IS NOT A PERMIT. THIS APPLICATION MUST GO THROUGH A SIMULTANEOUS REVIEW PROCESS <br /> WHERE ZONING, SEPTIC (IF APPLICABLE) AND CONSTRUCTION PLANS ARE CHECKED PRIOR TO THE <br /> ISSUANCE OF A PERMIT. IT IS THE RESPONSIBILITY OF THE APPLICANT TO ASSURE THAT ALL <br /> NECESSARY INFORMATION IS PROVIDED. ~S SOON AS ALL REQUIREMENTS OF THE REVIEW HAVE <br /> BEEN MET. YOU WILL BE NOTIFIED THAT YOUR PERMIT HAS BEEN ISSUED, <br /> <br /> [~] I am the PROPERTY OWNER and own, reside in, or will reside in the completed <br /> structure and will be my own general contractor. I understand that I must <br /> register as a construction contractor if the structure is sold or offered for <br /> sale before or upon completion. If I hire subcontractors. I will hire only sub- <br /> contractors registered with the Construction Contractors Board. If I change my <br /> mind and do hire a general contractor who is registered, I will immediately <br /> notify Marion County of the name of the contractor. <br /> [ ] I am the CONTRACTOR registered with the State of Oregon. <br /> [ ] I am an AUTHORIZED REPRESENTATIVE of the property owner or contractor. <br /> SIGNATURE OF APPLICANT:-"~' O~xyvv~ F~)~A,u~ <br /> <br /> Marion County Building Inspection <br /> 3150 Lancaster Dr. N.E., Suite C Salem, Oregon 97305-1398 <br />Office Hours: 8:00-4:30 Phone: (503)588-5147 24-hr Inspection Line: (503)373-4427 <br /> <br /> <br />