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MARION COUNTY BUILDING INSPECTION <br /> COMMUNITY DEVELOPMENT CEN IER <br /> 285 Chumh St NE - Room 132 <br /> Salem, Oregon 97301 <br /> <br /> BUILDING PERMIT APPLICATION <br /> <br />COMPLETE ALL SECTIONS. i THROI~JGH 4 <br />1, JOB DESCRIPTION <br /> <br />RESIDENTIAL <br /> ( ) Addition <br /> <br /> ( ) 3,1teeatio~) <br /> <br />R~location <br />Other <br /> <br />COMMERCIAL <br /> <br /> ( ) Addition (~) <br /> New <br /> <br /> ( ) Alte~:atiun ( ) gig0, <br /> ( ) Changeof O¢cupalcy ( ) Other <br /> <br />FOR CYI .Y_, ..USE ONLY <br /> <br />2. I, OCATION OF INSTALLATION <br /> <br />Lot <br /> <br />Pgone N,, <br /> <br />Pri~te Well ( ) Spring <br />Comlnunity Well ! ) City <br /> <br />3. CONTRACTOR INFORMATION ~ PLEASE INDICATE WHO IS DOING THE WORK <br /> <br /> [ lvlaili0g Addre~ xJ Phone <br />4. FEE SCIt~DULE <br /> <br />on~quacef00tgg~o£project) Valtlatton $ ,~'-9~/d- <br /> Wit <br /> <br /> <br />