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FOR CI.%VALI~_~_~O~N <br /> <br />Zoning Validation: <br />Date: q-- 1'7"~ ' <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> COMMUNITY DEVELOPMENT CENTER <br /> 285 Church St. NE - Room 132 <br /> Salem, O~gon 97301 <br /> 8:00am4:~0lnn PImm~ $88-$147 <br /> ~4 hr. Inspection Line 588-7~0~ <br /> FAX $88.7948 <br /> <br />COMPLETE ALL SECTIONS, 1 THROUGH 4 <br /> <br />IFOR CITY USE ONLY I <br /> City ~tha~ R~: <br /> <br />BUILDING PERMIT APPLICATI~ 2 1 - 9 72 '5A09: 5 7 I fl <br /> <br />1. JOB DESCRIPTION <br /> <br />RESIDENTIAL COMMERCIAL Use of Stmcture: <br />(~ddition ( ) Relocation ( ) Addition ( ) New C..-~t~O O,~n~~-' <br />( ) Alteration ( ) Other ( ) Alteration ( ) Sign <br />( )Accessory ( )CheflgeofOccupancy ( )Other <br /> <br />2. LOCATION OF INSTALLATION t,~? ~/,~wz.~t=,~a~ x.~. <br /> <br />3. CONTRACTOR INFORMATION -- PLEASE INDICATE WHO IS DOING THE WORK <br /> <br /> (~ I am an AUTHORIZED REPRESENTATIVE of the p~pe~y orator or <br /> <br />4. FEE SCHEDULE <br /> <br />(3) Reinspem~m Fm· $~.00 <br /> <br />I hereby certify that the above information is correct; <br />Permits are non-tronsferrable and expire if work is not started within 180 days of issuance or if work is suspended for 180 days. <br /> <br />Name of Applicam (Please ~nt): ~- ~ ~7~° Phone: <br /> <br />· or~ -s 7f- z~ <br /> <br /> <br />