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FOR CIT.Y VALIDATION <br /> <br />Zoning Validation: I <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> COMMUNITy DEVELOPMENT CENTER <br /> 285 Church St. NE - Room 132 <br /> rtVO_ <br /> 8:00am'4:3Opm Phc~A~L~ J ~ ~ [ \VI ~ <br /> <br /> BUILDING PERMIT{~II~L~IOI~ '[SS6 <br /> <br />COMPLETE ALL SECTIONS, 1 THROUGH 4 <br /> <br />FOR CITY USE ONLY <br /> <br />( ) Addition ( ) Rel~afion ( ) Addidon ( ) N,w <br />( ) Altem~on ( ) O~er ( ) Alteration ( ) Sign <br />( ~Acccsso~ ( ) Change of~cu~pcy ( ) O&er <br /> <br />2. LOCATION OF INSTALLATION <br /> <br />3. CONTRACTOR INFORMATION -- PLEASE INDICATE WHO IS DOING THE WORK <br /> <br />( ) I am the PROPERTY OWNER ami own, reside in, or will reside in thc completed structure and will be my own g~neral contractor. I understand that I must mgis~r ~s a constracfion <br /> contractor if the structur~ is sold or offered for sale before or upon completion. If I him subcontractors. [ will hire only au beonteaetors r~gistm~ed with the ConsStuction Contractors Board. <br /> If I change my mind and do him a general contractor who is regisl~md with the Constraction Contractors Board, I will immgdiataly nc{ify Marion County 9fth~ name of the con.actor. <br />(~)~ I am a CONTRACTOR r~gistered with the Stat~ of Oregon. <br /> Business Name -- .~ Regish'afion NO. <br /> <br />() <br /> <br />I am an AUTHORIZED REPRESENTATIVE of the prop~ty owner or contractor. <br /> <br />4. FEE SCHEDULE <br /> <br />A. <br /> <br />VALUATION (Se~ "Valuation Schedule" to detcrminc valuation <br /> <br />(1)°n square fcotage of project.)Permit Fee Valuation: $ <br /> <br />I hereby certify that the above information is correct. <br /> <br />Permits are non-transferrable and expire if work is not started within 180 daya of issuance or if work is suspended for 180 days. <br />NameofApplicant(PlcasePr~t): f~ ~ L ,~ ~ Phone: <br /> <br />MC 15-73 Rev 1195 <br /> <br />=^L .$ Z/s.¢/ <br /> <br />7qq- z S'-7 <br /> <br /> <br />