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Clef <br />.Rece!ved By. ~ <br />Zoning Validation: <br /> <br />Date .. <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> COMMUNITY DI~VELOFMI~NT CIgNTER <br /> 285 Church St, NF~ - Room 132 <br /> Salem, Oregon 97301 <br /> 8:00am.4:30pm Phone 588-$147 <br /> 24 hr. InSpection Line 588-7904 <br /> FAX $88-7948 <br /> <br />I FOR CITY USE ONLY <br /> <br />COMPLETE ALL SECTIONS, 1 THROUGH 4 <br />1. JOB DESCRIPTION <br /> <br />RESIDENTIAL <br /> <br /> ( ) Addition <br /> <br /> ( ) Alteration <br /> (L,"f Accessory <br /> <br /> BUILDING PERMIT APPLICATIONcoMMERCiAL ~f~//'ffP/'ff~ U ~m~c~:~] ~11 ::~ <br />( ) Rel~ation ( ) Addition ( ) New ~ <br />( )0~cr ( )Alaration ( )Sig~ 10~' <br /> ( )Ch~ofOccu~cy ( )Oa~ BUILDING INSPECTION <br /> <br />2. LOCATION,OF INSTALLATION ~]~ 0f ~ 70 '? / <br /> <br />3. CONTRACTOR INFORMATION -- PLEASE INDICATE WHO IS DOING THE WORK <br /> <br />4. FEE SCHEDULE <br />A. <br /> <br />on square footag~ Of proj~:g~.) : Vo~u~oa: $ <br />(I) Pexmit Faa <br /> <br />(3) Structural pl~ ~*Vlew 665% x Al) <br /> <br />I B, Mis~ql~ncous <br /> <br />=$ <br /> <br />I hereby certify that the above information is correct. <br />Permits are non-transfemlble and expire if work is not started within 180 clays of issuance or if work is suspended for I80 days. <br /> asr Print ); _~_~'~-..-~.,] :~~__~ <br />Nameof,Appficant(Ple ~'~ __Phone; ff"a 7~= .,~. ~'-~=~ff~ <br /> <br />MC 15-73 Rev I~ <br /> <br /> <br />