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I.nOR .CITY VALIDATIONI <br />eCelve~l By: __ <br />g-~alidafion: <br />at& <br /> <br />COMPLETE ALL SECTIONS, 1 THROUGH 4 <br /> <br /> 1. JOB DESCRIPTION <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> COMMUNITY DEVELOPMENT CENTER <br /> 285 Church St. NE - Room 132 <br /> Salem, Oregon 97301 <br /> 8:O0am4:30pm Phone 588-5147 <br /> 24 HR lmp~cfion Line 588-7904 <br /> FAX $88-7948 <br /> MANUFACTURED DWELLING <br /> PERMIT APPLICATION <br /> <br />FOR CITY USE ONLY <br /> <br />New Placement Garage or Caqmrt <br />Replacement ( ) At~ached <br />Additional Unit Add-on ( ~ Detached <br /> ¥., of No. o, ,vid <br />Ty~ of Si~ng:) W~d (~Tm °f ~fi"g:~ Square F~ta~]S /R No. of B~ms: ~ <br />~ ( ) S~I Pit S~: ~r~: <br /> <br />2. LOCATION OF INSTALLATION <br /> <br />Mobile Home P~k N~: <br /> <br />Ufl~an Growth Boundary? ( ) Yes ~*~ No <br /> <br />Irt. Lot: 8 Comer: <br />WatcrSuppl¥: ~)PrlvateWe ( )CoramunityW¢lt ( )City <br /> <br />3. CONTRACTOR INFORMATION -- PLEASE INDICATE WHO IS DOING THE WORK <br /> ( ) I ~m ~ae PROPERTY OWNER and own, reside in, o~ will reside in the completed structure and will be my own general contractor. 1 und~stzed that I <br /> must reglst~r ~s a consm~ction co~tractor ff the structure is sold or offered for sal$ befor~ or upon completlo~: If I hir~ subcomractors, I will him only <br /> <br /> ) <br /> <br />4. FEE SCHEDULE <br /> <br />I hereby certify thzt thc above information is con'ect. Permits are non-transferrable and expire if work is not started w~ <br /> <br />or if work is suspended for 180 days. <br /> <br /> <br />