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I'.FOR CITY VALIDATION <br /> <br /> Received By: __ <br /> <br /> Zoning Validation: <br /> <br /> Date: <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> COMMUNITy DEVELOPMENT C F_2q'I~R <br /> 285 Church St. NE - Room 132 <br /> Salem, Oregon 97301 <br /> 8:00am.4:~pm Phon~ ~8~-$147 <br /> 24 br. Inspection Line $88.~4 <br /> FAX $88-7948 <br /> <br />City S~o~ck P. equiremea~: <br /> <br /> BUILDING PERMIT APPLICATION <br />COMPLETE ALL SECTIONS, 1 THROUGH 4 ~-2~ Cg. O(~ <br />1. JOB DESCRIPTION <br /> <br />RESIDEKVtAL COMMERCIAL U~e of <br />( )Addition ( )Relocation ( )Addition ( )New <br />~Alteration ( ) Other K) Alteration ( ) Sign <br />( ) Accessory ( ) Change of Occupancy ( ) Other <br /> <br />2. LOCATION OF INSTALLATION <br /> <br />3. CONTRACTOR INFORMATION -- PLEASE INDICATE WHO IS DOING THE WORK <br /> <br />Name Reg/stra/ion No. <br /> <br />4. FEE SCHEDULE <br /> <br />( 1 ) Permit Fee <br /> <br />(2) 5% $ta~e Surcharge (.05 x Al) <br /> <br />I hereby certify that the above information i~ correct. <br />Pe~rmit s are non-transferrable and ex_p~wol:k is not siar~ed within 180 days of issuance or if work is suspended for 180 days. <br /> <br />MC 15-73 R~v 1/95 <br /> <br /> <br />