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FOR CI[T,Y'VALIDATION <br /> <br />Zoning Validation: <br /> <br />COMPLETE ALL SECTIONS. 1 THROUGH 4 <br /> <br />MARION COUNTY BUILDING iNSPECTION <br /> COMMUNITY DEVELOPMENT CENTER <br /> 285 Church SI, NI~ - Room 132 <br /> Salem, Oregon ~7301 <br /> 8:00am-4:30pm Phone S88-S147 <br /> g4 hr. Inspection Line $88.7904 <br /> VAX SSS.*04g J <br /> BUILDING PERMIT APPLICATION <br /> <br /> FOR CITY USE ONL~ <br /> <br />Loft Si,r ..... id¢; <br /> <br />L JOB DESCRIPTION <br /> <br />RESIDENTIAL COMMERCIAL ' U'se of Str~etute: ' ' <br />( ) Additi0D ( ) Relocation (~"~Additlon ( L.~ew <br />( ) Alteration ( ) Oth~ ( ) Alteration ( ) Sign <br />( ) Accessory ( ) Changeof~cupancy ( ) Other <br /> <br />2. LOCATION OF INSTALLATION .~,vv~ _~ ff] o ~/?~,/g ~ ~ . <br /> <br />~m~a,l/~ Or~ q~S2s~ __ <br />.... ~ Privat~W¢ll ( ) Spring ( ) <br /> <br />3. CONTRACTOR INFORMATION-- PLEASE INDICATE WHO IS DOING TH~ WORK <br /> <br />4. FEJg SCHEDULE <br />A. <br /> <br />VALUATION ($~ "Valuation Schedule" to deterrain¢ valuag0n based ] <br /> <br />(6) ,q*i~mie Surcharge = <br /> <br />(2) Investigation <br /> <br />(3) Reingpeetion Fee @ <br /> <br /> '9/0,7 <br /> <br />TOTAL =$ "~-~/'~ ~ <br /> <br />1 hereby certit'y that the abow in~ivrmatJon is correct. <br /> <br /> <br />