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F?R C}TY VALIDATION <br />Received By: <br /> <br />Zoning Validation: <br /> <br />Date: ,, <br /> <br />MARION COUNTY BUILDING INSPECTION / FOR CITY USE ONLY <br />COMMUNITy DEVELOPMENT CENTER <br />285 Church St. NE - Roonl 132 [CityCity SeIbavk Requi,vcmems: <br />Salem~ Oregon 97301 F~m} <br /> <br /> FAX 588-79~ <br /> <br /> ( ) New Placement I Garage or Carport <br /> ( '~ Replacement ( ) Attached MARION COUNTY <br /> <br />Type of Siding: Type of R~fing: S~uat'e Footage: ~ $O No, of g~rooms: ~ <br />) Wood ( ) Comp <br />(~) Metal ( ) Stol Pit,Set: Energy: <br />) V inyt (~) Metal <br /> <br />2. LOCATION OF INSTALLATION <br /> <br /> Mobile Hom~ ParkNam~; ~ /~ <br /> <br />Property Owner: <br /> <br />$¢¢0on: . i~ <br /> <br />[ <br /> <br />3. CONTRACTOR INFORMATION ~ PLEASE INDICATE WHO IS DOING THE WORK <br /> <br />4. FEE SCHEDULE <br /> <br />(in¢ludgs EL. Pt.. ME eon.*¢tions) <br />State Surcharge $12.2~ <br />Stal~ Fee $20.00 <br />ZOnlng Surcharge (i f applicable) $20.00 <br /> <br />TOTAL <br /> <br />$60,0O = <br /> <br />o,' if work b suspended for 180 days. <br /> <br /> <br />