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FOR CITY VALIDATION <br />Recolved byL <br />Date: <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> COMMUNITY DEVELOPMENT CENTER <br /> 285 Church St NE- Room 132 <br /> PERMff NO: <br /> Salem, OR 97301 <br /> <br /> Date: <br /> 24 hr. Inspection Line 373-4427 <br /> <br />PERNUTS ARE NON-TRANSPERAnLE AND EXPIRE I~ WORK I$ NOT <br />STARTED WITHIN 180 DAYS OF ISSUANCE OR 1F <br /> WORK IS $USPP~IDED FOR 180 DAYS. <br /> <br />2A. COHTRACTOR INSTALLATION ONLY <br /> <br />2B. FOR OWNItR INSTALLATIONS <br /> <br />Prope~ Owr~ (please print) <br /> <br />3. PLAN RBVIEW 8BCTION <br /> <br />Marion Couatydaea~;g ~ltfire a.plaa review, ,. .... ~ ?t .. <br />We will provide plan review service if you complete <br /> / <br />Section 5B and submit two (2) sets of plans and <br />specificatioos with this application. <br /> <br />MC 15-34 1/96 <br /> <br />A. Rmidemial per Unll <br /> <br /> Re~n~l only ~.~ 2 <br />D. Br~n~ <br /> <br />b) The ~,e f~ ~,...-b ¢~rcu/~ wiamal <br />Each a~dim~nd brach cn~mt <br /> <br />$35.00 <br />$ 2.00 <br /> <br />E. Mi~e~laae~, (Servle~ ~r P~mde~ N~ Included) <br />~ch pump ~ ~plion ci~ ~.~ 2 <br /> ~ch 8i~ or oudme Ii,lng ~.~ ~ 2 <br /> <br /> ~t the allowable in any of ~ <br /> <br />H. 0~ <br /> (An re~d by ~ddi~ ~ciaD <br /> <br />5. P~S <br /> Al. Eme, r totnl of fee~ ~om Sec. ~4 <br /> A2, A~ 5% ~ (.05 x A I) <br /> $.~ <br /> <br /> B. Enter 25~ <ff line Al t~r Plan Review <br /> <br /> D; Re~ ~e (~,~) $,~ <br /> ~T~ ~O~.D~ $ <br /> <br /> <br />