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FOR CITY VALIDATION <br /> <br />MARION COUNTY BUILDING iNSPECTION <br /> COMMUNITY DEVELOPMENT CENTER <br /> 285 Chu~h Si. NE - Room 132 <br /> Salem. Oregon 97301 <br /> 8:00am.4:30pm Phone $S8-5147 <br /> 7.4 hr. I~speetion Line $88-7904 <br /> FAX!S88-7948 <br /> <br /> FOR CITY USE ONLY <br /> <br />Left Sid¢:~.,~- ! I Right <br /> <br /> ONE & TWO FAMILY DWELLING <br /> <br />JOB DESCRIPTION <br /> ( ) New Sblgle ~amily Dwelling With Attaeh~ G~ge ~ <br /> <br />3. CONTRACTOR INFORMATION -- PLEASE INDICATE WHO IS DOING THE WORK <br /> <br /> ( ) <br /> <br /> ( ) <br /> <br />Block <br /> <br />Community Well ( ) Cby ( L)~~' <br /> <br />FEE SCHEDULE <br /> <br />VALUATION: <br /> <br />PLAN REVIEW FEEt <br /> <br />DWelling labele must be obtained at Marion County Building Inspection and <br />mechanleat work. Col~tact Marion County fi}r ~nstruction$, <br /> <br />B. PERMIT FEES <br /> <br />must be placed at the jobsite prior to inspection for plumbing, electrical and <br /> <br />I hereby certify that the above information is correct. P~rm: s are non-transfewab e and expir~ f work is not started within 180 days of issuance or if work is suspended for <br />180 days. I <br />NameofApplieant(PleasePr, m): Phon~: 2t"/9 / / Y ~ <br /> <br /> <br />