Laserfiche WebLink
lFORpFFm Sy. pNLYI <br />Received by:~ <br /> Zoni.ng Validati?W ff fF" I <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> <br /> ' Salem, OR 97301 ]ci~y s~t~ck R~ni~u; I <br /> g:00~m~:~0~m~ ~S-~m I~~t: '"" /~ ' 1~?: ~ ~ i <br /> C~e-A-~ 588-79mF~ 588-7948 [~ft S~de: /~' ~gbt Side: /~ t I <br /> <br />COMPLI:iTE ALL SECTIONS, 1 THROUOH 4 ~-" ~ <br /> <br />2. Location oflngtallation ,~,'~/e.,~, ~rc.. <br /> <br />3. Conncactor information <br /> <br />( ) i un.rotund ~a[ I must m~s~r as a c~st~ ~ntmc~ ff ~e s~m is sold or offered for sale b~om or u~n <br />( ) I wiU be my own gmeral contm~. <br /> <br />If I him subcontractors, ~ will him only subcontractors mglstered with the Construction Contractors Board, <br /> <br />[f [ ch~g¢ my mind and do hire a general contractor, I will contract with a c~tractor who is registe~d With the Constmctlon Contractor s Board, and w <br />/mmcdiau:ly notify Marion County of the name of thc ,ontraeior.,. . t~¢~., ~¢ ~tJ~ ~, 1~- ~f~/d~/~.~ ¢~J <br /> <br />( ~am a registered builder OR the aufhotizlM repms~ntatlve of a resJstetegl hitild ex. "' <br />Authorized agen orb:as M~ ~dd.ss ..... {Phone: <br />4. Fee Schedule ~e~[, ~,~, ~Z~tt ~.r ~l)~ c] 7.,~ f&$- <br /> <br />A, (I) Manufactured Home <br /> or Modular Unit Phc. e. mmt/Conncctlon <br /> <br /> (2) State Fee <br /> <br /> (3) State Surcharge <br /> <br />B. (1) Mfg.'d Structure Storage Fe~ <br /> (2) Mlg,'d Structure Storage Renewal <br /> <br /> (3) Zoning $umhatg¢ (I5.00 if applicable) <br /> <br />@ smoo;/~,q', <br /> <br /> C. Additional Inspectic~x <br /> 20,00 --,,,,a!~:.~" 0: or ReAnspe~tlon <br /> 930= 9HO <br /> 15.00 --~ 2..,~t~ D, Investigation Fee <br /> TOTAL $~3~.,,,.~//O E, Otherlnsp~¢tiOnSnotlisted @ $40.00= <br /> @ 40.00 per hour (2 hour minimum) <br />@ $25.00=__ <br />@ 25.00 :__ TOTAL= <br />@ <br /> <br />@ $60,00=__ <br /> <br />MC 15-64 Re,: 11-91 <br /> <br /> <br />