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RFOR OFFICF~USE OfiLY 1~ MARION COUNTY BUILDING INSPECTION FOR OFFICE USE ONLY <br />ec. elve. d By. ~ ~ ~ COMMUNITY D~V~LOPMENT CENTE~ <br /> <br /> /~ Salem. Oregon 97~01 F~n / Rear:: ~ ~ <br /> <br /> - BUmDmO PERM~ APPLICA~ ~ <br /> COMPETE ~L SECTIONS, 1 T~OUGH 4 FEB 2 ~ <br /> I. Job Description <br /> <br />2. Location of Installation /~ff~, .('.~. <br /> <br />Job Addm~ ~X/ ,,, ~//~ ~ ~ ~t l~x Acer No- Cross <br />d~ tn~ d~//e iff~ q 7~5' gimNo , ............................ <br />Subdividm ~ ~l~k <br /> q/ <br />Semon ~ 'lOwns~p ~X Range ~ ~ ~e ~ ~p Wa~rSvpply:: <br /> P~vate Well <br />L~Widm ff~/ L~';~h~/ Acres I~,,~t ~0 Comet ~ CommuMt3Won( <br /> <br />3. Contractor Information <br /> <br /> ( ) I o~ monde m. ~ wffi ~sid~ ~ ~c mmpleted ~mnm, <br /> <br />~f I h~e subcontractors. I will him oMy subcontractors registered ~ ~e Cons~ ~mm Bm~ ~ I chmge my md ~d do ~e a gme~l ~n/ra~, I $ tU mntmct <br />wi~ a contractor who ia mgiatemd wi~e ~tmcfi~ Cmwa~/o~s Bmrd. ~d wffi ~y n~y Marion C~ty of ~e name of ~e cmrracwt, <br /> <br />Fee Schedole <br /> <br />A VALUATION ($¢e "Valuation Se,.hcduld~ <br /> to determine valuation based on <br /> <br /> (1) Permit Fee <br /> <br /> (2) 5% Slate Surcharge (05 x Al) <br /> <br />(3) Structural Plan Reviaw (.65% x Al) ~ = <br /> <br />($) Zomng Suteharge~ if applicable (05% x Al) - <br /> <br />B,, MiscrZlanelms <br /> <br /> (1) Driveway w/curb @ $7.50 <br /> <br /> (2) Drive,~ay,Mo curb@ $17.00 <br /> <br /> (3) 8it¢ Phn Rcvlexv (corem,rein! <br /> <br /> O) Addifi~al Plan Renews or Addmdmx <br /> (5) hves~ga~m Fee <br /> <br /> (6) Rem~c~m Fee ~ $25.00 <br /> <br />M(' lq-7~ Rev 8/94 <br /> <br /> <br />