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COMPLETE ALL SECTIONS, 1 THROUOH 4 <br />1. JOB DESCRIPTION <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> COMMUNITY DEVELOPMENT CENTER <br /> 285 Church St. NE - Room 132 <br /> Salem. Oregon 97301 <br /> 8:00am*4:30pm Phone 588-5147 <br /> <br /> BUILDING PERMIT APPI~...~., --~2' <br /> PLA,'( 19 <br /> <br />FOR CITY USE ONLY <br /> <br /> RESIDENTIAL COMMERCIAL <br /> (.]a~dition ()Relocation (,Addition ()Ne~f~ 0~s~"~0~e: <br /> (~FAlterafion ()Other (X)Alterafion ()~IL{]I ~G ~~,,f,.~//d~ ·~x-~:~'f,e~ <br /> ( )Accessory ( )ChangeofOceupancy ( )Other <br /> <br />)escfiptioaofWork Remodel restrooms [ lslhisaMstofiealb~ilfling? Ye~ - (~ <br />EnergyPath: I No. sto~,s ]No. ofFanployee~:lSxlsfing-160 ,e,- none [No. mmoomv. <br /> <br />LOCATION OF INSTALLATION <br /> <br /> Shetler & Shetler I Mamns^ddmss PO BOX 489 m~No. 749-1900 <br />JobAddl~ss 945 Olney St. ~raxXcct. No. ~'~_~ Cm~S~ 9th <br />Aumsville OR 97325-0489 <br /> ' ~v~W~l ( ) S~ ( ) <br /> <br />3. CONTRACTOR INFORMATION -- PLEASE INDICATE WHO IS DOING THE WORK <br /> <br /> Blazer Industr±es, Inc. 50106 <br /> ~"m"s^~P0 BOX 489 Aumev±l~e OR 97325-0489 mo~ 749-1900 <br /> <br /> Marv±n R. She~er <br /> MailingAdd~ss PO BOX 489 Aumsville OR 97325-0489 m~ 74~-1900 <br /> <br />4. FEE SCHEDULE <br />A. <br /> <br />=$ <br /> <br />1 hereby certify that the above information is correct. <br />Permits are non-transferrable and expir~ if work is not started within 180 days of issuance orif work is suspended for 180 days. <br /> <br />an Marvin R. Shetler <br />Name of Applic t (Please P~t): <br />Signature of mpplieaot. }'~ ~ , <br /> <br />MC 15-73 Rev It95 <br /> <br />749-1900 <br /> <br />05/07/97 <br /> <br /> <br />