Laserfiche WebLink
FOR OFFICE USE ONLY <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> 220 High Street NE <br /> Salem OR 97301 <br /> <br /> 800am-430pm Phone 588.5147 <br /> Code-A-Phone 5813-7904 <br /> FAX 588-7949 <br /> <br />FOR OFFICE USE ONLY <br /> <br /> DWELLiNG/STRUCTURAL AND/OR SEPTIC PERMIT APPLICATION <br />COMPLETE ALL SECTIONS, i THROUGH 4 <br />1. Job Description <br /> <br />RESB')IiN'I IAL COMMERCIAl, <br /> Ne~vSFDw/garaoe [ ] Acce~o~ [ 1 New [ ] Sxgn <br /> Ne~ SFD ~?ogarage ] ] Reloca~ [ ] AgdRion [ ] Demo <br /> Addition [ ] Demo ~ ~ [ ] Alteration [ ] Oth0r <br /> Akerati,m ~ ~her ~ ~, ~ [ I Chang~Occupan~ <br /> <br />2. Location of Installation <br /> <br /> Tax Acer, NO. Cro~ Stree4 <br />S~tion /y,, 'lownship ~g Range i ~ 7~ne Ma~ WatetSupply <br />lot W~dth / lint [>q~ Acm~ I~eg,, ~t Comer Private <br /> /~ / /~,¢ ~ Community Wag <br /> <br />3. Contractor Information <br /> <br />4. Septic Information (Check where applicable) <br /> <br />5. Fee Schedules <br /> <br />A <br /> <br />C <br /> <br />D <br /> <br />(1) Sq Fl __x 2.8 <br />(2) 5% State Surcharg~ (05 x A 1 ) <br />(3) Base Fee for Hah Revth,~ <br />(4) Zoning Sureh.~,rge (If Applicabte) <br /> <br />(1) Permit Fee <br />(2) 5% $Ia~c Surcharge (,05 x Fl I) <br />(3) Zotxing Surcb. atge ( 0S x RI) <br />(4) Plans Check ( 65 x B1 ) <br /> <br />Septic Fees (Includes DEQ Surcharge) <br />(1) Site Ewluation <br /> <br />O) Authorization Notice <br /> <br />(5) Major Rep~,r <br /> <br />185.00 <br /> <br />Subtotal:: <br /> <br />Subtotal;: $ <br /> <br />(1) Dw~cway W/curb (~ $?,50 = <br /> <br />(3) Site Plan Review (cmme~ial ~mly) ~ $79~ = ~ <br />(4) ~estigati~ Fee <br /> <br />(6) O~er ~spe~tons notalisted abo~ e ~_ x 540 = ~ <br /> <br />Receipt:: <br /> <br /> <br />