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FOR CITY ¥~LIDATION <br /> By:' '/,~-~-- 4~ ~n-~. <br />Izoning Validation: ,_~j~ <br />IDate: ~-~ ~S <br /> <br />COMPLETE ALL SE~ONS, 1 THROUGH 4 <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> COMMUNITY DEVELOPMENT CENTER <br /> 285 Church St. NE - Room 132 <br /> Salem, Oregon 97301 <br /> 8:00am-4:30pm Phone 588-5147 <br /> 24 hr. InSpection Line 588-7904 <br /> FAX 588-7948 <br /> <br /> BUILDING PERMIT APPLICATION <br /> <br />eFORC[TY,,,US_.E .ON_LY <br /> tback Requiremen~ <br /> <br />1. JOB DESCRIPTION <br /> <br />RESIDENTIAL COMMERC~AL N~ew Use of Structu're': <br />( ) Addition ( ) Relocation ( ) Addition ( <br />( )Al~mfio~ ( )Other ( )Alteration <br />(~ccesso~ ( )Ch~ofOeeupaney ( )Other <br /> <br />2. LOCATION OF INSTALLATION <br /> <br />3. CONTRACTOR INFORMATION -- PLEASE INDICATE WHO IS DOING THE WORK <br /> () <br /> <br /> --0 t2. 7 <br /> <br />4. FEE SCHEDULE <br /> <br />A. <br /> <br />VALUATION (Sea "Valuation 8;h~:iule" to deterrnln, valuation baaed <br /> <br />on square foolag, of project.) Valmltion; $ <br /> <br />TOTAL :$ <br /> <br />Signature of Applicant: <br /> <br />gqO -ot <br /> <br /> <br />