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FOuR CIq;Y VALIDATION <br /> <br />Zoning Validation: ff <br />Date: /gL'//~/~- <br /> <br />COMPLETE ALL SECTIONS 1 THROUGH 4 <br />1. JOB DESCRIPTION <br /> <br />MARION COUNTY BUILDING INSPECTION [ FOR CITY USE ONLY <br /> COMMUNIT'I' D]gYELOPMEN'T (2ENTEP, ~ ~ ' <br /> 285 Church St. ~- .dom 132Salem, 0 ~;ity Setb., ..quir~n,en,,: <br /> <br />RESIDENTIAL <br /> ( ) Addition <br /> <br /> ( ) Alteration <br /> <br /> COMMERCIAL <br /> / <br />) Relocation ( ) Addition ( ) New <br /> ( )Ch~of0~pmey ( )Other <br /> <br />LOCATION OF INSTALLATION <br /> <br />3. CONTRACTOR INFORMATION ~ PLEASE INDICATE WHO IS DOING THE WORK <br /> <br /> ( ) I am a CONTRACTOR registers0 wi~ th~ Slate of Omg0n, <br /> <br />4. FEE $CI'YEDULE <br /> <br />(4) O~h~r~tions not listed abOve <br /> <br />I hereby certiiy that thc above infotmallon is correct. <br />Pemaits are noa-transferrable and expiro if work is not started within 180 days of issuance or if work is suspanded for 180 days. <br /> <br />Signature of <br /> <br />MC 15-73 Rev~ <br /> <br />=$ <br /> <br /> <br />