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MARION COIJNTY BUILDING INSPECTION <br /> Senator Bldg, No. 225 <br /> 220 High ~tmer NE <br /> Salem, Oregon 97301 <br /> Phone 588-5147 <br /> <br />BUILDING INSP~iNo PERMIT APPLICATION <br /> <br />Mailing Addreee;; , J <br /> ,2,,/, ¢ <br /> <br />Job Address;: Site No,' <br /> Cross Street:: <br /> <br /> Inetaller:; Phone:: <br />Home Builder~ Regis[retion No :: <br /> <br />Residential:: New ~ Addition:: [] Occupancy Use of Building:: <br />Commercial:; [] Alteration:: [] Relocation;: [] Change:: [] <br /> <br /> NO FEE AMOUNT <br /> Base Price $20.00 <br /> Residential <br /> New construction (each fixture) ~ $ 900 .;~'~. O O <br /> Alterations ( .e..a,c,h fixture) 900 <br /> Re-located Residence (each fixture) 4,50 <br /> Commemial <br /> New C~onst ruction each fixture) 9.00 <br /> Alterations (each fixture) 900 <br /> Water Lines <br /> For the firet 100 feet or fraction thereof 20,00 <br /> For additional 100 feet 1500 <br /> Sewer Service Lines <br /> First 100 feet or fraction thereof $0,00 <br /> Additional 100 feet 1500 <br /> Mobile Home sewer~Netar connection <br /> (maximum 5 feet length) ............ 25.00 <br /> Other (as per OSP@C and"~ildlng Official <br /> On-Site Technical Review apply at Merion Cou. n..~,,,.o,nly <br /> Re-Inspection Fee 25 00 <br /> FEE $ <br /> STATE SURCHARGE <br /> PLAN REVIEW FEE $ <br /> INVESTIGATION FEE $ <br />Please return COMPLETE APPLICATION FLEET SURCHARGE $ <br />with the indicated fee, CITY FEE $ ..~. "~ <br />TOTAL <br /> <br />( ) [amamgisteredbuilderOR( u)'theauthorlzedrepresenta[iveof SIGNATUREOFAPPLICANT <br /> a registered builder <br />( ) The work will be performed by e registered builder <br />( ) Other <br /> <br /> <br />