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FOR CITY VA~LIDAT, IgnN <br />Received By: <br /> <br />Zoning Validation: <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> COMMUNITY DEVELOPMENT CENTER <br /> 285 Church St. NE - Room 132 <br /> Salem, Oregon 97301 <br /> 8:00am-4:3Opm Phone S88-$147 <br /> 24 hr. Inspection Line 588-7904 <br /> FAX s88-7948 <br /> <br />FO.___~R CIT.____~Y USE ONLY <br /> <br />RESIDENTIAL COMMERCIAL .... Use of Str~cture: ' ~ · ~ <br /> ~,,,~Addifion < ) Relocation < ) Addition MARION COU,N'I~,w F~rr~ t L Y ~,~ o ~ <br /> ( ) Alteration ( ) Other ( ) A]t~,~,i,~UILDING INSPEC~T~,~I <br /> <br />COMPLETE ALL SECTIONS, 1 THROUGH 4 <br /> <br />1..]'OB DESCRIPTION <br /> <br />2. LOCATION OF INSTALLATION <br /> <br />3. CON~. RACTOR INFORMATION -- PLEASE INDICATE WHO IS DOING THE WORK <br /> (~"'~ I am the PROPERTY OWNER and own, reside in~ or will reside in the completed suucture nd will be my own general contractor. I und~stand that I must register as a construction <br /> <br />() <br /> <br />Business Name Registration NO. <br /> <br />4. FEE SCHEDULE <br /> <br />A. <br /> <br />VALUATION (Se~ "Valuation Schedule" to determine valuation basod <br />on sqgarc footage of project) Valuation: $ ~ <br /> <br />TOTAL <br /> <br />=$ <br /> <br />:, <br /> <br />I hereby certify that the above information is correct. <br />Permits are non-transferrable and expire if work is not started within 180 days of issuance or if work is suspended for 180 days. <br /> <br />Name of Applicant (Please Print): Wlf]/~J~q~l [~; ~ ~"~ /~]C ~ ~ IP,., Phone: <br /> <br /> <br />