Laserfiche WebLink
MARION COUNTY BUILDING INSPECTION <br />220 High Street NE <br /> Salem, OR 97301 <br /> 8:00am.4:30pm Phone 588-5147 <br /> Cede-A-l~on~ 588-7904 <br /> FAX 588-7948 <br /> <br />[FOR OFFICE USE ONLY <br /> <br /> ONE & TWO FAMILY DWELLING PERMIT APPLICAT~II~ ~ <br />COMPLETE ALL SECTIONS, 1 THROUGH 4 ~~[~ <br />1. Job Description <br /> 9 <br /> <br />) New Single Family Dwelling w/o garage ( ) Garage, delached <br /> <br />BUILDING INSPECTION <br /> <br />'"~'ectio~W~kJ~J~Township ~ Range ~ Zen* ~ ............. Map WaterSu~ly: ..... <br /> <br /> PdvateWell ( ) Spring <br /> ~Width ~ 'L~D*~h ~O,' Acres ~g.'~t~o ~mer fro Commu~tyWell( ) City <br /> <br />3. Contractor Information~. <br /> <br /> (gl i own, reside in. or will rcsld¢ in the completed structure. <br /> ( ) I understand ~hat I most register a~ a construction eontr,',,c-tor if the structure is sold or offered for sale b~for~ or upon completion. <br /> <br /> ()~) ! will b~ my own general contractor, <br /> <br />If I hire subcontractors, I will hire only subcontractors registered with the Collstrllction Contractors I~ ~ard. If I change my mind and do lfire a general contractor <br />who is registered with the Constraction Contractor's Board, I will immediately notify Marion County of the name of the ¢ontracor: <br /> <br />' Contractor Bu$illegs nme & #: ] Maihng Address: [ Phone: <br /> <br />( ) I am a registered builder OR the amhorl~gd re~esentafive of a registered builder. <br /> <br />4. Fee Schedule <br /> <br />A, New One-and-Two Family Dwelling Code <br /> (inlcudes El, Mt~, P1) <br /> <br /> B, Miseellan¢cms Fees <br /> $~/~,~Z,~,r_d (1) Driveway w/~urb @ $7.50 <br />Valuation: <br /> <br /> (2) ~iv*way w/o crab ~ $17.~ <br /> <br /> (3) Additional Plan Revi*ws or Add~du~ <br /> <br /> (4) Inve~gafion Fee <br /> <br /> (5) Reinfection F~ ~ $25.~ <br /> (6) ~0rlns~efion~ not Ibmd ~v~ <br /> <br />Name or Appllcant (Plc;as~ Print): t~ 1 ~ el.~-~ t~l ~g a,_ r., Pi,one: <br />g gila ute of AplSlieant: Date: ~7 <br /> <br /> <br />