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FOR CITY V~AIJDATION <br />I%eceivcd:By'. ~'(:z~ ~-~ <br />Izoning Validation: .d'ff/ ~ <br />I Date: /..2- / 3' 4~''~' <br /> <br /> MARION COUNTY BUILDING INSPECTION / FOR CITy USE ONLY <br /> COMMUNI'P~' DEVELOPMENT CENTER <br /> 285 Church St. NE - Room 132 City Setback F. equiremcnts: <br /> Salem, Oregon 97301Riglu Side: <br /> 8100am-4:30pm Phone588-5147 Front: Rear: j~ <br /> 24 HR Inspection Line 588-7~4 e~ SlOe: <br /> FA~ ~-79~ <br /> MANUFACTURED DWEL~ <br /> <br />JOB DESCRIPTION <br /> <br />' Oar3ge or Carport ~'~ <br />( ) Replacement <br />( ) Add[tionut Unk Add-on ( <br />'l'ype ~f Siding: Typeot'RoO~ng: Square Footage:/~ N0, of ~oms: ~ <br />, (~oofl ~ Comp <br /> <br />Xt 2. LOCATION OF iNSTALLATION <br /> <br />3. CONTRACTOR INFORMATION -- PLEASE INDICATE WHO IS DOING THE WORK <br /> ( ) <br /> <br />4. FEE SCItEDULE <br /> <br />A. Manul~etue~d Placomenl~onr~**tions $245,00 = ~'~i'~, ~ <br /> (includ~ EL. PL, ME connections) <br /> ~ate Su~harge $12,25 = /,~ <br /> <br /> TOTAL <br /> <br />$60.00 = <br /> <br />or if work is suspended for 180 days, , <br /> <br /> <br />