Laserfiche WebLink
FOR CLT._.~ VALIDATION I MARION COUNTY BUILDING INSPECTION FOR CITY USE ONLY <br /> <br /> / 0~.//1 I Salem, Oregon 97301 <br /> <br />· ~ _ 24 hr. lml~eflon Line ~ <br />Vat . ? - .o <br /> BU~D~G PE~IT APPLICA~ <br /> <br />RESIDENTIAL COMMERCIAL <br />(~Addition ( )Relocation ( )Addition ( )New <br />( )Alteration ( )Other ( )Alteration ( )Sign <br />( )Accessory ( )ChangeofOccupancy ( )Other <br /> <br />2. LOCATION OF INSTALLATION ~. V. ~.~ o.~ Z ~' <br /> <br />3. CONTRACTOR INFORMATION -- PLEASE INDICATE WHO IS DOING THE WORK <br /> <br /> () <br /> <br />I am the PROPERTY OWNER and own, reside in, or will reside in the completsd s~rucmm and will be my own g~n~ral conti'a~or. I undm~l~nd tha~ I mast r~gi~t~r M a coI~nl~iion <br />coratactor if thc structure is sold or offered for sale b~ fore or upon completion. If I hire subconlractur% I will hire only sal~onnectun registered with th~ ComneCllon Conlm~tor~ <br /> <br />I am an AUTHORIZED REPRESENTATIVE of the property owner or contractor. <br /> <br />4. FEE SCHEDULE <br /> <br />A. <br /> <br />=$ <br /> <br />I hereby certify that the above information is correct. <br />Permits are non-transferrable and expire if work is not starred within 180 days of issuance or if work is suspena%d for 180 days <br /> <br />MC 15-73 Rev 1/95 <br /> <br /> <br />