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MARION COUNTY BUILDING INSPECTION <br /> COMMUNITY DI~VBLOPMENT CENTER <br /> 285 Church ~t, NB - Room 132 <br /> <br /> S alem~mgoa 97301 <br /> 8:00am-4:~ 1~18e..~8-5147 <br /> BUILD~G ~IT AP <br />COMPLETEi. JOB DESCRIPTIoNALL SECTIONS, 1 ~ROUdH 4 ~ ~ <br /> <br /> Uss ONLY <br />Fmnt:CitYS~backR~quirement~:R~r; /1~ i <br /> <br /> RESIDENTIAL COMMERCIAL O "-'tv · <br /> qlLbltll~, COUIIth. us~or <br /> <br /> (~Accesso~ ( )Ch~ofOcc~p~cy ( )O~et <br /> <br />~.~,~: i,~.~ U I I~°';f~vl°'~':~A'"""g- ~w- I~o.~om,: <br /> <br />2. LOCATION OF INSTALLATION <br /> <br />3. CONTRACTOR INFORMATION -- PLEASE INDICATE WHO IS DOING THE WORK <br /> <br />4. FEE SCHEDULE <br /> <br /> on square footage of project,) Va/uatim: $ -~/~t~, ~' <br /> <br />(4) Other Imr,~et~onanot listed above <br /> <br />i hereby certify that the above information is correct. <br />Permits are uon-trallsI~Ilable and expit~ if work is not ~tarted wlth[n I80 ~l~y5 of 15~uallce of if work is suspended for $0 days, <br /> <br /> <br />