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MARION COUNTY BUILDING INSPECTION <br /> SENATOR BLDG NO 22,5 <br /> 2~0 HIGCJ STREET NE <br /> SALEM, OREGON 97301 <br /> <br /> PHONE 588-5147 <br />CODE-A-PHONE 4 30 PM - 8::00 A M <br /> <br />SiGNA~fURE OF APPLICANT __ <br /> DATE <br /> <br /> CONTRACT CITY <br /> <br />'?.,':+:,4; C[~, ,- Ob T <br /> <br />UGt¢ <br /> <br />MAILING ADDRESS <br /> <br />SUBDIVISION <br /> <br />DEPTII <br /> <br />DP'c-'iN ~iE:,(i:. I' ,,-, <br /> <br /> - :" ~;"~ ' .......................................... Zv~:'~' ,~., E~ ,~ - <br />..... [ ~ ~ D(',)OU~J~kJ' FO~: ~/J]r''~¢c'r-q ,ki~':~ ~,,e~¢~ <br /> <br /> THIS IS ~ VALID PE~IT ~ THIS PEMIT ~PlRES 380 DAYS FR~ ITS !~UE <br />C~S:'~.ICT!ON FAILS TO MEBT ALL REdIReCTS OF STATE ~ ~!O ~RI~ ~UN~ <br />Z~;NG ORDzN~S. THZS P~ZT ~ALL BEdE NULL. AND <br /> <br /> <br />