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'jP.D. <br />Appl, Revd; <br /> <br /> CMERYL <br /> <br /> ~-9-~2 <br />Date: <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 />P.M.- ........... CODE-A-Phone 588-5373 ........... 8;00 A.M, <br /> <br />Permit No. ~~ <br />By; <br /> <br />Date: <br /> <br />Type of Permit; <br /> <br />HOUSE <br /> <br />Address: <br /> <br />Owner; <br /> <br />21599 DOLOi~$ W~:~Y <br /> <br />JAGI< i.. ,'.-d, {G <br /> <br />Sec. ____Twnshp, __Rge. <br /> <br />Bldr. & No.: <br />Plans by: <br /> <br />Map Page Zone Zone Chg, <br />Use of Dtdg.: <br /> <br /> Phone: Address: <br /> <br /> Phone: Address: <br />Part. , Co~d, IJseI Variance ' Fire Zone Occupancy~ \ Type of ConSt.r <br /> o~ gcc, Ld: "Min Req. Front Sides . Rea <br /> <br />Lot No; ,,, BIk. No: <br /> <br />Water Supply; <br /> <br />Sewage 2~:~ × 2~ <br />Disposal: ....... <br /> <br />Area of ildg; <br /> <br />Basement: <br /> <br /> Heating <br />System:, <br /> <br />BTU: <br /> <br />Sub dv, <br /> <br />Lot Size Corner}' <br /> <br />Site <br />~:vah <br />No, <br />Stories:. <br /> <br />Roof <br />Type: <br /> <br /> VaJuation: <br /> <br /> Permit Fee; <br /> <br /> State Surcharge: <br /> <br />stick <br /> Plans Chk. Fee: <br /> <br />46 °45 <br /> <br /> 1 <br /> <br />Septic Permit Fee: <br /> <br />Total Fees: <br /> <br />VALIDATIONS; <br /> <br />I agree to build ~cord/w o the submitted plans and specifications, the law~ of the State of Oregon and tbe Orldnances of Marion <br />County. Permit expires if ~rk not commenced within 120 days. I furht~r expressly warran~ that I comply wi~h the provisions of ORS <br />701.~5 to 701,125 because: <br />( ) lamar~is~eredbuilderor( ) theauthorlz~represen~ativeofar~/ster~builder <br />( ) Theworkwillbepefform~b~areglsteredbuilder <br />( ) I am performing ~rk on a prope~ I own or occupy <br /> <br />REMARKS; ~ / _/ . <br /> <br />PLEASE NOTE: Dr[ve'~way and sidewalk inspections ar~uired by Public Wot s: <br /> Other permits required by this dept; Plumbing [] Electrical <br /> <br /> <br />