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FOR CITY V~LIDATION <br /> <br />IZoning Validation: <br />[Date: /,g-//6 <br /> <br />COMPLETE ALL SECTIONS 1 THROUGH 4 <br />L ,[OB DESCRIPTION <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> COMMUNITY DEVItLOPMENT CENTER <br /> 285 Church St. NI5 - Room 132 <br /> Salem, Oregon 97301 <br /> S:00am-a:~0pn~ Phone s~qe <br /> ~ hr, Inspection Line 5~1 <br /> FAX ~88-7948" <br /> <br /> BUmDING <br /> <br />FOR CITY USE ONLY <br /> <br /> RESIDENTIAL COMMERCIAL <br /> <br />( ) Addition ') Relocation ( ) A6dition <br />( ) Alleration ) Other ( ) Alteration <br />(¢4/Access°rY,~ I , ( ) Change of 0cct~pancy <br />Description of Woek <br />~.emy Pa~: No, Storie~ <br /> <br />( ) <br /> <br />( ) Sign <br /> <br />( ) Other <br /> <br />[~ ~11~ SO of Structure; <br /> <br />LOCATION OF INSTALLATION <br /> <br />3. CONTRACTOR INFORMATION -- PLEASE INDICATE WHO IS DOING THE WORK <br /> <br /> ( ) <br /> <br />I hereby ccrlify that th~ above intbrmafion is correct. <br /> <br />Permits are non-transferrable and expire if work is not started within 180 days of is~uanc~ or if work is suspended for 180 days. <br /> <br />Signature of Applicant: -, ~ ~/~T'~- <br /> <br />es <br /> <br /> <br />