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FOR CIT, Y VALIDATION <br /> <br />MARION COUNTYiBUILDING INSPECTION <br /> COMMUNITY DEVELOPMENT CENTER <br /> 255 Church Sk NE - Room 132 <br /> Salem, OregOn 97301 <br /> 8:00am-4:~0pm Phone 588-5147 <br /> 24 hr. Inspgeflon Line 5118-7904 <br /> FAX 588-7948 <br /> <br />COMPLETE ALL SECTIONS, 1 THROUGH 4 <br /> <br />BUILDING PERMIT APPLICATION <br /> <br />IFOR CITY USE ONLY <br /> <br /> LefiSide: /RightSlae; ~ / <br /> <br />RESIDENTIAl. COMMERCIAL Use of Structure: <br />( ) Addition ( ) Relocation ( ) Addition ~ New <br />( ) Alteration ( ) Other ( ) Alteration ( ) Sign <br /> <br />2. LOCATION OF INSTALLATION <br /> <br />L CONTRACTOR INFORMATION -- PLEASE INDICATE WHO IS DOING TIlE WORK <br /> <br /> ( ) i am the PROPERTY OWNER nnd own, tesl¢l~ in, or will aBi~ in the eorord{t~i sml~ar* and will he my own gene4'al contractor. I understand ~hat I must register as a ¢omtm¢fion <br /> <br /> I am a CONTRACTOR ~gistr. I~d with the State of Ot~$0n, <br /> <br />R*gistration NO, <br /> <br />I hereby certify that the above information is correct, <br /> <br />Name of Applicant (Please Print):-. <br /> <br />MC 15-73 ~v 1/95 <br /> <br />(i) AOdiliona~ Plan Review* or Addandums <br />(2) Investigation ~ee <br /> <br />anco or if work is ansi>ended for 180 days, <br /> <br /> Phone: <br /> Dam: <br /> <br />=$ <br /> <br />/,o f Jo/ q r' <br /> <br /> <br />