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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG. NO, 225 <br />220 HiGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br /> PHONE: 588-5147 8:00 - 4:30 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />I ~m pedorming work Or~ e property [ own or OOCgpy. <br />ama(egister~d& builder OR( )theautho zedrepresenaive <br />et a registered builder. <br />fho work wdl be 0erformed by a registered builder <br /> <br />SIGNATURE OF APPLICANT: <br /> OATE: <br /> <br />CATEGORY: <br /> <br /> <br />