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iF~OR GITY V~LIDATION I <br />Received By: ¢ .~//J' <br /> Zoning Validation:' <br /> Date:, /~/~7 <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> COMMI_JNITy DEVELOPMENT CEIqTBR <br /> 285 Church St. NE - Room 132 <br /> Salem, Oregon 97301 <br /> 8:00am-4:30pm Phone g88-5147 <br /> 24 HR Inspection Line 588-7904 <br /> FAX $88-79a8 <br /> <br /> MANUFACTURED DWELLING <br /> <br />FOR CITY USE ONLY' <br /> <br />'~ Side; Right Side; <br /> <br />PERMIT APPLICATION <br /> <br /> )AdditionalU~itAdd-on ( )Detached t~A~tOal ~ ...... <br /> <br />of Siding: ~ Type, o¢ R~fiag: Square F~tag,: /2 g ~ No, of B~moms'. ~ <br />~ood i ( ~omp ..... <br /> <br /> Vinyl[( >Met.{ .... ~p f, ~. C-, <br /> <br />3. CONTRACTOR INFORMATION -- PLEASE INDICATE WHO IS DOING THE WORK <br /> <br /> ( ) <br /> <br />4, FEE SCHEDULE <br /> <br /> 2d .O0 = C° <br /> <br />$2o,~-$2°'°° ,, ~F- <br /> <br />$60.00 ~ <br /> <br />I hereby ¢~rtlfy that tho above information is correct, Permits am non-transferrable and expire if work is not started within 180 days of issuance <br />ac if work is suspended for 180 days, <br /> <br /> <br />