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MARION COUNTY BUILDING INSPECTION <br /> <br /> 220 High Street NE <br /> Salem, OR 97301 <br /> <br /> 8:00am - 4:$0pm phone 588-5147 <br /> Code-A-Phone 588.7904 <br /> <br />BUILDING PERMIT APPLICATIObF <br /> <br />COMPLETE ALL SECTIONS, 1 THROUGH 4 MAR/ON: COUNTY <br />L Job Description BUILDING INSPECTION <br /> <br />z. ofx.st U t o, /ash DR c/70 7 <br /> <br />Contractor Information <br /> <br />4. Fee Schedule <br /> <br />A. VALUATION (See 'Valuatica Schedule" <br /> lo dotcrmjlae valuation base~l on <br /> square <br /> (1) permit <br /> <br /> (2) 5% State Surcharge (.05 X Al) <br /> (3) Structural Plan Review 665% x Al) <br /> (4) :Fke & Life Safety Plan Review (.40% x A <br /> (5) Zoning Surebargc, if applicable 605% x A 1 ) <br /> <br />(1) Driveway w/curb@ $7.50 <br /> <br />(2) Driveway w/o eu/o @ $17.00 <br /> <br />O) Site Phn Review (commercial only) @ $79.00 <br /> <br />(4) Additional Plan Reviews or Addcndums <br /> <br />(5) Investigation Fee <br /> <br />(6) Reinsl~etim Fcc @ $25,00 <br />(7) Other ln~l~¢fions not listed above Q.d' ~ <br /> <br />I hereby ccnlfy that thc above information is correct and ~hat I have r~ad and understand thc lnfonratdon NOJ. ce~ to property <br />roverse sige ofthi~ form, <br /> <br /> Skc eva tlo~s, ~ptlc, ¢:tt~m~ plumb'~g and mechanical wo~ ~q~re se~ra~ ~ts. Ch~ck wi~ Mafi~ County B~ld~8 In~e~ ~fo~ submltt~g ~is ~plicafi~. <br /> <br />MC 15-73 Rev. 11/91 <br /> <br /> <br />