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COMPLETE ALL SECTIONS, I THROUGH 4 <br /> 1. JOB DESCRIPTION <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> COMMUNITY DEVELOPMENT CENTER <br /> 285 Church St. NE - Room 132 <br /> Salem, Oregon 97301 <br /> 8:00am.4:30pm Phone 588.5147 <br /> 24 HR Inspection Line 588-7904 <br /> FAX 588-7948 <br /> <br /> MANUFACTURED DWELLING <br /> PERMIT APPLICATION <br /> <br />Front: <br /> <br />FOR CITY USE ONLY <br /> <br />"~,~,~New Placement Garage or Carport <br />( ) Replacement ,d$:~tached <br />( ) Additional Unit Add-on ( ) Detached <br />Dealers Year of ~ No, of Length --t Width <br />Type of Siding: Type of Roofing: Square Footage- / 7 <br />< )Wood N/tp~yZf____.~l,Y,~,~omp .......... . / ~ No, of Bedtooms: . ~ <br />( ) Metal ( ) Steel Pit Set: Energy: <br />(..~Vinyl ( ) Metal <br /> <br />2. LOCATION OF INSTALLATION <br /> <br />3. CONTRACTOR INFORMATION -- PLEASE INDICATE WHO IS DOING THE WORK <br /> ) <br /> <br />Phone: <br /> <br />4. FEESCHEDULE <br /> <br />Stat~ <br />Zoning Surcharge (if ¢,pplicable) <br /> <br />third inspection) <br /> <br />$60.00 = <br /> <br />hereby certify that the above information is corn:rot, Permits are noll4ransferrable and expire if work is not stated within 180 da s of i~uance,._ <br /> <br /> L./'zw<c,'w _P.o.,,, <br /> <br /> <br />