Laserfiche WebLink
k <br /> ~pR CITY VALiDATION]MARION COUNTY BUILDING INSPECTION FOR CITY USE ONLY <br /> Received By: f~../~ Jify VI/~.-~ COMMUNITY DEVELOPMENT CENTER <br /> 285 Church St. NE - Room 132 City Setl~k R~quirements: <br />Zoning ValidaJion: / ~ [ Salem' Ore~ii~q~ltP' f~'~ '-- ~ lot. <br /> <br />COMPLETE ALL SECTIONS, , THROUGH 4 BUILDING PERMIT AI~%l__V.[~S~q~ION '~7.,~llt <br />1. JOB DESCRIPTION BUIL~W,. <br /> <br />RESIDENTIAL COMMERCIAL "~ <br />(~ddition ( )Relocation ( )Addition ( )New <br />( ) Alteration ( ) Other ( ) Alteration ( ) Sign <br />( )Accessory ( )ChangeofOccupancy ( )Other <br />iDescription of Work <br />t ..oor: <br /> <br />2. LOCATION OF INSTALLATION <br /> <br />3. CONTRACTOR INFORMATION ~ PLEASE INDICATE WHO IS DOING THE WORK <br /> <br />() <br /> <br />Mailing Address <br /> <br />4. FEE SCHEDULE <br /> <br />(2) Investigation F~ <br /> <br />O) Relnsl~gtion Fe~ 0 $25.00 <br /> <br />(4) Other Iasl~cllons not lis~d above <br /> <br />.$ <br /> <br />=$ <br /> <br />I hereby certify that the above information is cermet. <br />Permits are non-transferrable and expir~ if work is not stared within 180 days of issuance or if work is suspended for 180 days. <br /> <br />Name of Applicant (Pleas ~ ~ ~.~ ~ ~'c4'~ Phone: <br />Signature of Applicant:~ ~tte: <br />MC 15-73 Rev 1/95 <br /> <br /> <br />