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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG. NO. 225 <br />220 HIGH STREET NE <br /> SALEM, OREGON 9,~01 <br /> <br /> PHONE 58~-5147 <br /> CODE-A-PHONE 4:30 P-M. ' 8:00 A,M. <br /> <br />I am performing work on a property i own or' occupy. <br />I am a registered builder OR ) the authorized representative SIGNATURE OF APPLICA <br />of a registered builder- <br />otb., 7-3/ <br /> <br />USE OF BUILDING: <br /> <br />MAILING ADORESS: <br />LOT: <br /> <br />AREA: ' ¢ UNITS: ¢'4 ~"~ IRREG. LOT; :CORNER: <br /> <br />MAR: <br /> <br /> <br />