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• <br /> La - oo 3 s (-cg-- 4cTE <br /> „, 'cultural or Forestry Building Exemption Certifica in E C E �/] E <br /> Equine Facility Exemption Certification UU <br /> uta U L; on County Public Works-Building Inspection Divis'•� <br /> MAY 15 2019 <br /> Maria? 5155 Silverton Rd.NE, Salem Oregon 97305 <br /> County, Phone: (503)588-5147 Fax: (503)588-7948 Email:building(a�co.marion.or.us <br /> OREGON ION <br /> COUNTY <br /> BUILDINGnINSPECTION <br /> Owner/applicant name: Re;rk Q- :p �)clL-Y..snn Phone:-51;3 y33 --S-961 Fax: <br /> Mailing address:1A$.S . 1,3v--(e.,`,.\,5 34-, kl C-- City/State: Sa.ke_rr) D('. Zip: q 73c <br /> Job site address:2.a ex-14. OE" City: S4 lie,A,.N Zip: ' 7. 3 <br /> Directions to the site: R �;. \,,,,1/45e_ t <br /> Proposed Building Information <br /> 1. Site plan is attached(required): X'es ❑No <br /> 2. Type of Exemption: Agricultural Building o Forestry Building ❑Equine Facility(provide information below): <br /> o Total number of stalls or equivalent number of horses: <br /> o Total number of stalls or equivalent number of horses limited to personal use only: <br /> o Total number of stalls or equivalent number of horses anticipated to be used for commercial or trade purposes <br /> inc.boarding,training,rental,haul-in, clinics, shows,etc. (consider future plans): <br /> 3. Is the use of the structure or the items within it used for any business or commercial activities?Nees o yl No,f <br /> If yes,please explain: �, 29� •� 0 ^ H 59 g.t.,01 c,As <br /> 4. Describe use of the building (and items contained within: Sn��J �- rn c c��Pvm nr C ca,-M <br /> P 4 i..: M T c r c\ 4 .. L -e S\-p.,6, ' r.-c c-e\-a . <br /> 5. Is the property in farm or forest deferral?. 'es ❑No <br /> 6. Is the proposed structure located within a floodplain? oYes )(No <br /> 7. Will the proposed structure have any of the following systems?(If yes,separate permits are required for each system): <br /> Plumbing oYes To If plumbing will be installed,what type of fixture(s)? <br /> Electrical oYes KNo <br /> Septic oYes )(No <br /> Heating/Cooling/Ventilation/Mechanical oYes 'No <br /> 8. Will this structure be used by the public at any time? oYes jlo <br /> 9. What is the proposed maximum number of people(including employees,owners,etc.)that will be present in the <br /> building at any one time? (,� S;, J ���' ^ •� n <br /> 10. Where will restroom facilities be provided? � ism �� ,;;rt \ \. `, <br /> 11. Is the proposed structure a manufactured home? oYes l'No <br /> 12. Building Data: Length: Li�' Width: LI T--)1 Area: )14\P)e1( Height: )a \\ ► e;,� <br /> 13. Parcel Information:Parcel Size: NI. Parcel No.: R k g',16, Zone: E 1.4 <br /> TAX LGT txp3 W)yC. c i51, <br /> Page 1 of 5 <br />