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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG, NO. ¢'25 <br />220 HIGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br /> PHONE: 588-5i47 8:00 ~ 4:30 <br />24 HOUR CODE-A-PHONE: 588~7904 <br /> <br />I am a registered builder OR ) the authorized representative <br /> <br />The work witl be 13erformed by a registered builder. <br />Other ' <br /> <br />AUHSVZI..LE OR 97325 <br /> <br />........... 2--, ...................... 2 .............. ~ <br /> <br />;;", '74'9--;I, 027 <br />'.C 1' E; H <br /> <br />PAYEE= <br /> <br /> ~ THIS IS NOT A PERM~. <br />FOLLOBINE MUST ~E <br /> LL NECESSARY INFORMAT: <br /> <br />QUANT:[TY <br /> <br />0 <br /> <br />F;{:;:""~ "- <br /> <br />FORM ill M~ 15.3~ REV. 4/'~0 OFFICE COPY <br /> <br /> <br />