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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 /> <br />FOR CiTY USE ONLY <br /> <br />COMPLETE ALL SECTIONS 1 THROUGH 4 dON 0 5 <br />1..lOB DESCRIPTION ] <br /> <br /> 24 hr. Inspection Line 588-7904 <br /> FAX 588-7948 <br /> <br />BUILDING PERMIT APPLICATION <br /> <br />RESIDENTIAL COMMERCIAL <br />~Addition ( ) Rel~ation ( ) Addition ( ) New <br />( ) Alt~tation ( ) O~er ( ) Al~ration ( ) Sign <br />( ) Acccs~u~ ( ) Ch~geof~cup~cy ( ) O~er <br />2nergy Pa~: No, Stories ....................... <br /> <br />2. LOCATION OF INSTALLATION <br /> <br />3. CONTRACTOR INFORMATION ~ PLEASE INDICATE WHO IS DOING THE WORK <br /> <br /> PROPERTY <br /> <br /> Mldling Address <br /> <br />MARION COUN'FI <br /> <br />4. FEE SCHEDULE <br /> <br />(2) 5% State Sumhmege 605 x Al) <br /> <br />(3) Structural Plan Review 665% X Al) <br /> <br />(1) Additional Plan Reviews 0,' Add~lldoms ~ $ <br />(2) Investigation F~ <br /> <br />I hereby certify that the above information is correct, <br />Permits ave non-transti~rrable and expire if work is not started within 180 days of issuance or if work is suspended for 180 day*, <br /> <br />Signature o~ Applica ..... Date: <br /> <br /> <br />