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By, Chris <br /> <br />Date 6-3-86 <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 PM CODE-A-Phone .................. 8:00 AJvl, <br /> <br />,Date:: <br /> <br />Type of Permit <br /> <br /> 86-522 <br />Permit~c. ~3030 <br />By::__ <br /> Patty <br /> <br /> 6-12-~6 <br /> <br /> Septic Adequacy <br />Mobile Home P!a~emeD~H(~sbip) E~.=,. ~ __Tax LotNo,,:: <br /> <br />Address:: ,9567 Shoddy Dr. SE <br /> Donald Woolsey <br /> <br /> Sec:: 13 Twnshp :: ~ _RGB-, <br /> <br /> 769-3853 same <br />· Phone;:· Address;: <br /> <br /> same <br />BIdr & NO ·Phone::·__ Address:: ....... <br /> <br />Plans by:: ·Phone: ~ddress:: <br /> <br /> MaP Pa¢e I Z°ne J Z°neChange62 [;FU Part, Cond Use 86-41 Vananco/Adj FT/FD Occupancy T¥1~e of Const <br /> <br /> or Ccc Ld I Min Req Front J 8,bes [ Rear <br />use st e,ds Res. NO BdrmS, 1 Setbacks ~"O ~ ,,~ O <br /> <br />Lot No:: .... BIk NO, <br />Area of Bldg 2nd <br />Main Fir, .Fir :: __ <br /> <br />Root Type:: <br />Heating <br />System:: <br />Septic Tank <br />Site Eval,:; <br />Ex,st <br />System:: <br /> <br />yes <br /> <br />Wood <br />_Stove:: <br /> <br /> Sub, dy I ct Size_ 1 ac _Corner?· <br />Base- Total <br />__ment;: ___~Z~rea:: single Valuation:: ........ <br /> Bldg. Permit ~ 35 .g0 <br />Truss/Stick:: ........ Jfleight:: ................ Fee (+ 5%) ~ 1..75 <br /> Water <br /> _Supply:: well Elect. Fee::. 40.00 <br /> New <br /> Instal: Mech F(~e::, <br /> No <br /> Gals:: ? Plumb, Fee:: <br /> State <br /> <br />no <br /> <br />VALIDATIONS:: Surcharge, (4%) 3.00 <br />Zomn J~- , Fleet Surcharge 7.68 <br /> <br />I agree to budd according to the submittcd pl~and ~pecifications, the laws of the DEQ Surcharge:: 5. O0 <br />State of Oregon and the Ordinances of Marion County. PERMIT EXPIRES IF WORK <br />NOT COMMENCED WITHIN 180 DA YS I further expreesly warrant that I comply with TOTAL EWE:: Z52.43 <br />the provisions of ORS 701.005 to 701125 because,: BLDG, ~) ~R <br />( ) I am performing work on a property I own ( ) The work wig be performed DHveway ~ ~ ~ <br /> or occupy by a registered builder Permit Fee:: c <br />( ) I am a registered builder OR { ) the ( ) Other (please specify) Site Plan <br /> <br /> registered builder <br /> Public Works <br /> Receipt NO:: <br /> <br />I have reed this application in its entirety and certify that the stated information is true and correct to the beet of my know/edge <br />SIGNATURE OF APPLIOANTt~__~~¢~' ~ /.~'~~..~ '~ <br /> PLEASE NOT~riveway and sidewalk inspection are required by ~ic Works' 588-5036 <br /> Other permits required by this clapt; Plumbing ~ Electrical D Mechanical B <br /> <br /> <br />