Laserfiche WebLink
[FOR CITY VALIDATION <br />~Zoning Validatioa: <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> COMMUNITy DgVELOPMENT CENTER <br /> %g~ Church ~t. NB - Room 13% <br /> Salem, Dragon 97301 <br /> 8:00~mdg30pm Phone 558-5147 <br /> <br /> FAX $88-7948 <br /> <br />COMPLETE ALI. SECTIONS, l THROUGH 4 <br />1. JOB DESCRIPTION <br /> <br />BUILDING PERMIT APPLICATION <br /> <br />RESIDENTIAL <br />( ) Addition ( ) Relocation <br />( ) Alteration ( ) Other <br /> <br />COMMERCIAL <br /> <br /> ( ) Addition ~ <br /> New <br /> <br /> ( ) Alteration ( ) Sign <br /> ( ) Chrmge of Occupancy ( ) Otber <br /> <br />3eserlption of Work i ~l.~ ~.~t I ~- ( ,, ,%~.. /nt-i ~ ,z~7. ~.~~- <br />Zn~gy Path: I No. Smr[es [ -lqo. Or Employeet~; EMsfing · New- <br /> <br />IFO~R CI~US~E ONLY <br /> <br />2. LOCATION OF INSTALLATION <br /> <br />3. CONTRACTOR INFORMATION -- PLEASE INDICATE ,WHo IS DOING THE WORK <br /> <br /> ( ) <br /> <br /> Registration No, <br /> <br /> (~ t am an A~JTHORIZI~D REPRF~F~NTATIVE of toe property owner o: contractor,: <br /> <br />4. FEE SCIt~DULIg <br /> <br />(1) Additional Plan Reviews or A6dendums <br />(2) Investigation bee <br /> <br />I hereby certify that the above information is correct. ' <br />Permits are non-transferrable a~d expire if work is not started within I 0 days of issuauee or if work is suspended for 180 days. <br /> <br />Name of Applicant (~ease Print): <br /> <br />Signature of Applicant: <br /> <br />MC 15-73 Rev U95 <br /> <br />Dar,; __]~[30!ff{5- <br /> <br /> <br />