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County Commissioners Chief Administrative <br /> Danielle Bethel!,ChairSal Officer <br /> Colm Willis Jan Fritz <br /> Kevin Cameron <br /> Director <br /> OR FGON Brian Nicholas <br /> Deputy Director <br /> Dennis Mansfield <br /> MARION COUNTY PUBLIC WORKS <br /> RPM CONSTRUCTION LLC <br /> 475 MCNARY AVE NW <br /> SALEM, OR 97304 <br /> REQUEST FOR PERMIT EXTENSION <br /> If you have made progress at the site and the original permit is less than four years old <br /> from the issuance date, complete the information below to apply for a 180-day extension <br /> for the permit(s). <br /> Name: Phone: <br /> Address: <br /> Permit: 555-25-001493-STR Job Site: 5373 FAITH AVE NE <br /> You may apply for an extension if you need additional time to complete the work and the <br /> following apply: <br /> a) The permit is less than two years old from date of issuance, or; <br /> b) The permit will reach two years after the issued date and at least one construction <br /> inspection has been approved, and; <br /> c) It has been less than four years since the permit was issued. <br /> EXPECTED COMPLETION DATE: <br /> I acknowledge that I am actively working on this project and the project has not <br /> been abandoned. <br /> SIGNED: DATE: <br /> PLEASE ALLOW 5 BUSINESS DAYS TO PROCESS EXTENSION REQUESTS. <br /> Please send the completed form to: Marion County Building Inspection <br /> 5155 Silverton Rd <br /> P.O. Box 14500 <br /> Salem, OR 97309 <br /> If you prefer you may email a scanned copy to: building@co.marion.or.us <br /> or fax to: (503)588-7948 <br /> 5155 Silverton Rd NE—P.O.Box 14500--Salem,OR 97309-503-588-5147--www.co.madon.or.us <br /> Printed on recycled paper—Reduce-Reuse-Recycle-Recover <br />