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FOR CITY VALIDATION <br />Received By: __ <br /> <br />Zoning Validation: __ <br /> <br />Date: <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> COMMUNITy DEVELOPMENT CENTER <br /> 285 Church Si. NE - Room 132 <br /> Salem, Oregon 97301 <br /> 8:00am.4:30pm P'aone 588-5147 <br /> 24 hr. Inspection Line 588-7904 <br /> FAX S88-7948 <br /> <br /> BUILDING PERMIT APPLICATION <br /> <br />COIvlPLETE ALL SECTIONS, I THROUGH 4 <br />1. JOB DESCRIPTION <br /> <br />RESIDENTIAL COMMERCIAL Use of Structurex <br />(.~Addition ( ) Relocation ( ) Addition ( ) New <br /> <br /> Alteration ( )Other ( ) AheratJon ( ) Sign <br /> ( )Accesso~ "Q. lafl'~, ~ )~h._~ofO¢¢upancy ( )Other <br /> <br />2. LOCATION OF INSTALLATION <br /> <br /> ~vamWeft ~ S~n~ <br />Width ~t Depth Acres f ~ ~ I~g ~t C~er ~m~ Well <br /> ) <br /> City <br /> <br />3. CONTRACTOR INFORMATION -- PLEASE INDICATE WHO IS DOING THE WORK ET~ ~ ~0 <br /> <br />Name <br /> <br />4. FEE SCHEDULE <br /> <br />A. <br /> <br />I hereby certify that the above informa on s correc <br />Permits arc non-transferrable and expire if work is not staffed within 180 days of issuance or if work is suspended for 180 days <br /> <br /> <br />