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MARION COUNTY BUILDING INSPECTION <br /> SENATOR BLDG NO, 22,5 <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 />The work will be performed by a registered builder <br />Other ,, <br /> <br />SIGNATURE OF APPLICANT <br /> DATE <br /> <br /> L..~ GONTRA¢'i' .................. CITY UGS O~CUPANT LOAD <br />USE OF BUILDING IN0 0F BEo~00MS <br /> <br />TYPE: <br /> <br />PF~E¥:]'I:RtS RFCE J::PTS <br />TH]:~ R~ CE::[PT <br /> <br />~ THIS IS NOT A PER~IT. THIS ~PPLICATION ~U~T GO THRObGH A REVIEW PROCESS ~HERE THE <br />FDLLD~]N~ ~UST DE ~DMPLETED. IT IS THE RE~PDN~D[LITY OF THE ~PPL[g~HT TO ~SS~E THaT <br /> LL ~]EggSSARY [NF~REAT[~N HAS DEEN PROVIDED. <br /> <br />C,[TY <br /> <br />~o.~ .MC *~-~ ~ ,~ OFFICE COPY <br /> <br /> <br />