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FOR CITY VALIDATION] <br />a&,~,~a by: __ <br />Date:__ , ' <br /> <br /> MARION COUNTY <br />{BUILDING INSPECTION DIVISION <br />3150 LANCASTER DR NE - SUITE C <br />SALEM OREGON 97305-1398 <br /> <br />~RICAL PERMIT APPLICATION <br /> P/ease complete.all Sections, I through <br /> <br />I. LOCATION OF ~IST~TION <br /> <br />MARION <br /> <br />~T~NNS~J,%S ~ sm, nu~ m WOR~ m ~0~ <br /> <br />2A. CONTP,.ACTOR II~TALLATION ONLY <br /> <br />Date: <br /> <br />Issued by: <br /> <br />$35.00. <br /> <br />$50.00 <br /> <br />' tO ~l~d~l ¢ontractorO <br /> <br />tdf l.~l~.I* .... N/C <br /> <br /> <br />