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By: JODY <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 />Date: 9/15/82 <br /> <br />Type of Permit; ~ ~I]~MING POOL <br /> <br />Address: 12433 Agi~DT ROAD AUROiQJ, 97002 <br /> <br /> RIC[-IARD. HkENER ~40 <br />Owner: ~T~ POOLS''~~C~ ~C <br />Bldr. & No.; '~~5 <br />Plans b~: ~' ' ~hone: <br />Ma e ~n , Zon~ Chg,,;~ <br /> <br />Permit No. ~ --//-~ / <br /> <br />By:" <br /> <br />Address: <br /> <br />CLACKA~.iAS <br /> ~7015 <br /> <br />(~ccupancy___ Type of .Con,t. <br /> <br />Lot No.:-- BIk. No.: Sub dy .... <br />Area of Bldg. 2nd Base- Total <br />Main Fir.. Fir.. ment, Area. <br /> <br />Roof Type: . Truss/Stick: ' <br />Heating Wood Water <br />System:, Stove: . Supply: <br />Septic Tank New <br />Site Eval:. Instal, :. <br />Exist, No, -. <br />System: ,,__ Gals., <br /> <br />VALIDATION.~: A1 <br />Zoning: ¢ ~ ¢~/1~'1~7 Mechanical: <br />Date; ...... ~._ / ~'/ ~"~' Date:. <br />Septic Tank: <br />Date;,__ <br /> <br />Date, <br /> <br />I agree te build according to the submitted plans and specifications, the laws of the State <br />of Oregon and the Ordinances of Morion Counh/. Permit expires if 'A, ork not commenced <br />within 180 days. I further expressly warrant that I comply with the provisions of ORS <br />701.005 to 701.125 because: <br />( ) I am performing work on a property I own or occupy <br /> } I am a registered builder OR the authorized <br /> representative of a registered b' ' bilder <br /> <br />LotSize '70 ~n~Corner?.__ <br /> <br />Valuation: :' <br />Bldg. Permit ~J <br />Fee (+ 5%)1 <br /> <br />Elect. F~e: . , 10 ~ t~(~ <br /> <br />Mech. Fee: <br /> <br />P bmb, Fee: ' ' <br /> <br />State <br />Surcharge: 3- 99 <br /> <br />Plans Chk, Fee: <br />Septic Tank <br />Permit Fee; <br /> <br /> DEQ Surcharge~ <br /> <br />( ) The work will be performed by a registered builder <br />( ) Other (please specify) <br /> <br />REMARKS; <br /> <br />I h~ve read th/$ application /n it¢ entirety and certify that the stated /n£ormatlon is true end correct to the best of my knowledge. <br />SIGNATURE OF APPLICANT'~ //~/*s~/~ <br /> Other permits r~uir~ b~ this dept: Plumbing ~ El~trical]' ~ <br /> <br /> <br />