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FOR ,CITY VALIDATION I <br />k~ceived ~y: ~'~ <br />Zoning Validation: <br />Da,e: l Wq/. <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> COMMUNITY DEVELOPMENT CENTER <br /> 285 Church St. NE - <br /> Salem <br /> <br /> 8:00am-4:30pm Phone <br /> .M hr. Inspection Line <br /> FAX <br /> BUILDING PERMIT APPLI~.~,TIO~. <br /> <br />FOR CITY USE ONLY <br /> <br />Right$id~: /0 t <br /> <br />1. JOB DESCRIPTION <br /> <br />2. LOCATION OF INSTALLATION <br /> <br />3. CONTRACTOR INFORMATION ~ PLEASE INDICATE WHO IS DO1NG THE WORK <br /> <br />4. FEE SCHEDULE <br /> <br />TOTAL <br /> <br />=$ <br /> <br />I hereby ce~fy ~hat the above information is correct, <br />Permi~ are non-transferrable and expire if work is not s~arted within 180 days of issuance or if work is suspended for 180 days. <br /> <br />Signalare of A pp lie aa t: ~-~~ ~ ~ .Date: <br />MC 15-73 R~v 1~95 <br /> <br /> <br />