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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG. NO. 225 <br />220 HIGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br /> PHONE:588-5147 8:00- 4:30 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />lamaregister~dbdlderOR( ) the authorized representative <br /> <br />SIGNATURE OF APPLICANT: <br /> <br /> DATE: <br /> <br />........................................... NO OF BEDROOMfi <br /> <br /> I ARZA: ~ UNITS'. IRREG. LOT'. J CORNER'. <br /> <br />PERMIT OR APPLICATION NO: 9057884 <br /> <br /> TOTAL A~SES~i~I) FEilES ...... <br /> <br /> THIS ~$ NOT A PERHiT. THI~ APPL~gATIO~ ~UST GO THEOUSH REVIEW PROg~ <br />FOLLOWING ~ST BE CQMPLETED. ~T IS T4E RESPONSIBILITY OP THE APPLICANT TO ASSURE <br />'T~AT ALL NECESBARY INFORMATIQN HAS= <br /> <br />FO~ I* ~C ~s,so R~'. 4mo OF FICE COPY <br /> <br /> <br />