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MARION COUNTY <br /> DEPT. OF BUILDING INSPECTION <br /> Senator Bqildlng # 225 <br />Apph Recd~ ~¢'$~/ ,-- 220 High St., N.E. 2nd Floor Permit No ......... <br /> <br />By; ~O~te Salem, Oregon 97301 <br /> 588.5147 - 588-5148 By:_ Y~ <br />D,te: 5/ ?/s3 5:00 P.m.. ........... COO .A-Pha,e e8.537 ........... 8,00 A.m. Oa, : & <br /> <br />Type of Permit; Sitework & Foundation (Convenience Store) <br /> Tax Lot No; <br /> 21690 <br /> <br /> Dolores & Jack Isberg 222-2935 Address Aurora, 0me On 97002 <br />Owner: Phone: : 11320 S~a~ksburg Rdo <br />Blen&No.: Kraxber~er, Const. Co?hone; 266-3388 ..... Address: Ca~bY, 0re. gon ..97013 ...... <br /> - 10320 S~W~ Wash~ <br />Plan~ by: Ri chard L, Webb, Archt~hone: 292-9432 ~ Ad~ress; ~ortland~0reg~n 72~ <br /> <br /> Service/Conve~ence Store ~,O~.L~: ~a Setb~ks; 20 ft. 8 ft~ 8 ft.__ <br /> <br />Lot No ...... BIk. No,= .... Sub dy, _ , <br />Area of Bldg, 2nd Base- Total <br />Main Fir ....... Fir,: ..... merit: .... Area:_f <br /> <br />Roof Type~ ......... Truss/Stick:__ <br />Heating Woad Water <br />System: ............... Stove: Supply: <br />Septic Tank New <br />Site Eva[: .... Instal <br />Exist. No, <br />System; ......................... <br /> <br />VALIDATIONSi <br /> <br />Dote; ~'7'~i <br />Septic Tank: <br />Date: ............. <br /> <br />Mechanlcah <br /> <br />Lot Size ..... Corner? .... <br /> <br />Valuofiom <br />Bldg, Permit <br />Fee: ( + 5%). <br /> <br />Elect. Fee; __ <br /> <br />2.32 <br /> <br />Math, Fee: ...................... <br /> <br />Plumb. Fee: ................... <br />State <br />Surcharge: ............ <br /> <br />Plans Chk. Fee: ...... <br />Septic Tonk <br />Permit Fee- <br /> <br />I agree to build according to the submitted plans and specifications, the laws of the Stcffe DEQ Surcharge: <br />of Oregon and the Ordinances of Marion County, Permit expires if Work not commenced 80.82 <br />within 180 days. I Further expressly warrant that I comply with the provisions of ORS TOTAL FEE: <br />701,005 to 701.125 because; <br />( )lomperforming~arkonapropertylownoroccupy RECEIPTNO.: ~'~ ~c~-_~ <br />( ) I am a registered builder OR ( ) the authorized { ) The work will be performed by a registered builder <br /> representative of o registered builder ( ) Other (please specify) <br /> <br />REMARKS; <br /> <br />This application is for a Sitework & Foundation Pez~mit oralyo <br /> <br />See attached cover letter, <br />-~d~ ti o naZ"irm'ormat ~ on ~ <br /> <br />drawings and documents for <br /> <br />,SIGNATURE OF APPLICANT; ......... ~'-:.~:~,/".~ ~ ......................... <br /> PLEASE NOTE'~Y~eway and sidewalk inspectio.9~are required by Public Works: 588-5036 <br /> Other permits required by this(dept: Plumbing <br /> <br /> <br />