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MARION COUNTY BUILDING INSPECTION <br /> <br />FOR OFFICFc'IJSE <br />Received <br />Zoning ~al~ati~n: <br />Date: <br /> <br /> 220 High Street NE <br /> Salem, OR 97301 <br />8;;00 am-4:30pm Phone <br /> <br />MANUFACTURED <br /> <br />COMPI t;'l E ALI. SEC'I ION,S. 1 TIIROUGII 4 <br /> <br />[FOR OFFICE USE ONLY] <br />/City Setback Requlrcm¢~lts <br /> <br />ILeftSxde;; ],&~-t IR~gh~Side:: I~/ [ <br /> <br />Job Description <br /> <br />2 Location of Installation ~~, ~ q TJX3- <br /> <br />JobAddmss ,d~,t// ~S.t~Z/7. 2~- ~x Ac~ N~,: .... Ct°ss Street ,.,,~J~X <br />.....~qp~[i,ymo. ~ }~'i~ ~rban G~wlh Bounda~? <br /> <br /> .......................... PnvateWel[ ( ) Spring ( ) <br /> ...................,,,,,,,.,,~, (~mmt~m~yWe~( )Ctty ( ) <br /> <br />3, Conu'actor InformaUon <br /> <br /> ) I own, msule m, or vail reside ha the completed stmaure, <br /> <br /> ) I under~tand that ! must register as a o:mslra¢fion contractor ff the stnlaule is sold or offered for sale before or upon completmn, <br /> <br /> ) I w~ll be my own general contractor, <br /> <br />4,, Fee Schedule <br /> <br />A (I) Manufactured l-inme <br /> <br /> or Modular Unit Placement/Connection <br /> (2) State Fee <br /> <br /> (4) ~?"!ng ~':.d.~,~= (:5 30~r op~Eeable) <br /> <br />a (i) M£g 'd Structure Storage Fee <br /> @ $ 25.00 <br /> 2) Mfg:d Smlctum Storage Renewal @ 2500 <br /> (3) Zoning Surcharge (1500 if applicable) @ 15.00 <br /> <br />C- Additional Inspection <br /> or ReJnspection <br /> <br />D, Invesugauon Fee <br /> <br />E, Other inspections not lismd <br /> @ 40,00 per hour (2 hour mimmum) <br /> <br />@ $60 O0 = _ <br /> <br /> <br />