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.~pl. Recd~ <br /> <br />Date: 4-1 ~6-84 <br /> <br /> MARION COUNTY <br />DEPT. OF BUILDING INSPECTION <br /> Senator Building # 225 <br /> 220 High St. N.E. 2nd Floor <br /> Salem, Oregon 97301 <br /> <br /> 588.5147 - 588.5148 <br />5:00 P.M.. ........... CODE-A-Phone 588-5373 ........... 8:00 A.M. <br /> <br />Type of Permit: <br /> <br /> 84- 782 <br />Permit No. <br /> <br />Address: <br /> <br />Owner: <br /> <br />5-17-84 <br /> <br /> cr <br />By: <br /> <br /> S~COND FArM B~,T,ING <br />MOBILE HOME. SITE EVAT,: ~.~mr~ % .~iECT?.!C.~.ax Lot No: <br /> <br /> 1243~, ARNDT RD NE ATT~OPA <br /> <br />R/CHARD HAENER Phone: 678-1540 <br /> <br /> ...... Twos p. <br />Address: .......same <br /> <br />Bldr. & No.: private <br /> <br />Phone:, Address: <br /> <br />Plans by; Phone: <br />Map Page/ 2;g b Zone Ctlg, ] Par~',: ~ (~.~, i (~ Canal- Use <br /> <br /> Address: <br /> <br />' Mtn Re<l. Front Sides <br />lSetbeCks: ,~ I ~,,(~,,~" ~(~) Rear, <br /> <br />Lot No,' BIk, No.: , Su~ dy. __ <br />Area of Btdg, 2nd Base- <br />Main Fir.: .~ Fir.:__ lent. <br /> <br /> Lot Size 7C~ ~_Corner?.__ <br /> Total <br /> Area:,.. 12 x 55 Valuation: <br /> 'Bldg. Permit <br /> , Fee: ( + S%). 35,00 <br /> o1.25 <br />Water 40.00 <br />Supply:-- Elect. Fee: <br /> <br />Roof Type: Truss/Stick: <br />Heating Wood <br />System: ..... Stave: <br />Septic Tank New <br />Site Evah .......... Instal · <br />Ex;st, No, <br />System- , ..... Gals,' <br /> <br />VALIDATI,~NS: <br /> <br />Date: <br />Septic Tank: ~/~ ~ "') .~ <br />Date: <br /> <br />Mechanical: <br /> Date:- <br />Plans: i~ ~C)~ <br />.Date: ~-- <br /> <br />I agree to build according to the submitted plans and specifications, the laws of the Slate <br />of Oregon and the Ordinances of Morion County. Permit expires if work not commenced <br />w;thln 180 days, I further expressly warrant that I comply with the provisions of ORS <br />701,005 to 701. 125 because: <br /> ) t om performing work an a property I own or occupy <br />( <br /> <br />Mech. fee:~ <br /> <br />Plumb. Fee: , ...... <br />State <br />Surcharge: ~.~O <br /> <br />) I am a registered builder OR ( ) the authorized <br /> representative of a registered builder <br /> <br /> Plans Chk. Fee:-- <br /> ~[/ Septic Tank -140.O0 <br />'~/~'~'~. Permit Fee: ~..~. 00 <br /> <br /> DEQ Surcharge: ~,0 ~ 00 <br /> TOTAL FEEt ~'h'~5~,, ?' <br /> <br /> RECEIPT NO.= <br /> The work will be performed by a ~glstered builder <br /> Other (please specify) <br /> <br />REMARKS; <br /> <br />SIGNATURE 0F'APPL.ICANq ~/~ <br /> PLEASE NOTE! Driveway and sidewalk inspections are required by Public Works: S88-5036 <br /> Other permits required by this dept: Plumbing [] Electrical [] <br /> <br /> <br />