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OFRCE ~Y <br />Received by: <br /> <br />MARION COUNTY BUILDING <br /> <br /> Salem, ~ 97301 <br /> Phone 588-5147 8,'~ a,,m. - 4;30 p.m <br /> <br />FOR OWI'JER Jt~Sl'ALLA'/1QNS <br /> <br /> I <br /> <br />CitylState/Z[p <br /> <br />The Inst~lladon is bolng made on property I own which rs not intended for safe, <br /> <br />Issued by: <br /> <br />4. FEE SCHEDULE (Complete and enter total in A1 below) <br />Number of Inspections per permit allowed <br /> <br />A. Residential, Slegle or Items x Cost .. Tot~[ <br /> <br />3. PLAN REVIEW SECTIOfl <br /> Check apPropriate item and en~r fee in ~ection $~. <br /> <br />__ Connected Load over 200 amps (except single family dwellings) <br />__ Building system over 300 amps (except single family dwellings) <br />__ System over 600 ye)ts <br />__ Build~ng over 2 erodes <br />-- ~ail~ng ove~ 10,000 ~uam feet <br />. Occ~paof load over 300 persons <br />.., M~nuta~tumd Dwelling Pak/Recmation Pa~'k <br /> Hazardous Locations <br /> <br />Submit 2 sets of plans with any of file above, <br />Temporary eensa~z~fion services do not apply, <br /> <br />A~. Enter total of fees from Se~. ~4 $ ~0~O0 <br />A~. Add5% surcharge (.05xA~) $ :~ ,Oo <br /> <br />B. Enter 25% of llne A~ for Plan Review <br /> (Sec. 3), it required <br />C. Inves~gation Fee (if required) <br />D. Rebspec~on Fee ($25.00) <br /> <br /> TOTAL AMOUNT DUE <br /> <br /> <br />