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MARION COUNTY BUILDING INSPECTION <br /> COMMUNITY DEVELOPMENT CENTER <br /> 255 Chulmh St. NE - Room 132 <br /> Salem, Ore$on 97301 <br /> 8:00am.d:30pm Phone S88-5147 <br /> <br />FOR CITY__USE ONLY <br /> <br /> . <br /> <br /> BUILDIN <br /> <br />JOB DESCRIPTION - , <br /> <br />2. LOCATION OF INSTALLATION <br /> <br />CONTRACTOR INFORMATION -- PLEASE INDICATE WHO IS DOING THE WORK <br /> <br /> ( I I am thc PROPERTY OWNER and own, maide in, or will maid~ ia 1h¢ completed stoJctum and will ~ my own g~a~ral ~on~aet~. 1 und~rst~d tha~ I muat feglst,r as a ~ona~cfi0n <br /> <br />4. FEE <br /> <br />SCHEDULE <br /> <br />(3) S~rucmml Plan gcv~w (,6~% x Al) <br /> <br />Permits ate non-transferrable and expire if work ia not started within 180 days of issdance or if work ia suspended for 180 days. <br /> <br /> Phone: <br />Signature of Applicm~t: ~~ __Dam; <br /> <br />MC 15-73 Rev 1/95 <br /> <br /> <br />