Laserfiche WebLink
[DF~R CJTY VALIDATION] <br /> <br /> -,C.C' -/ <br /> <br />COMPLETE ALL SECTIONS. 1 THROUGH 4 <br />L JOB DESCRIPTION <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> COMMUNITY DEVELOPMENT CENTER <br /> 285 Chorch St, NE - Room 132 <br /> Salem, Oregon 97301 <br /> g!00am-4:30pm Phone 588.51a7 <br /> 24 he. inspection Line 588.7904 <br /> BUIL~~ON <br /> '-""-' APR 1 4 995 <br /> <br />ILcft Side: [Right Side: ~ ' <br /> <br />FOR CITY USE ONLY <br /> <br />RESIDENTIAL <br /> <br /> ( ) Addition ( ) Relocation <br /> <br /> ( ) Alteration ( ) Other <br /> ( ~A¢¢esso~y <br /> <br />COMMERCIAL MARION COUNTY <br /> ( )Aaai~I]ILDING INSPEdTIb'/~ <br /> ( ) Altcrafion ( ) Sign <br /> ( ) Change of O¢¢up~lcy ( ) Other <br /> <br />I Other: l Height: /2 __ <br /> <br />2. LOCATION OF INSTALLATION /F~¢ ;;;7, n n, u t//~ · ~ re. q <br /> <br />3. CONTRACTOR INFORMATION -- PLEASE INDICATE WHO IS DOING THE WORK <br /> () <br /> <br /> () <br /> <br />4, FEE SCHEDULE <br /> <br />A. <br /> <br />VALUATION (See"Valuation Schedule" m &ter~ia~ valuation baaM <br />on sqo~m footage of p~oje~,) Valuation: $ _~,~1~, ~'~ <br /> <br />(i) ?cnnit Fee 4/~...~ <br />(2) 5% State Sv~hoxg¢ COS x Al) ~* ~ <br />(3) S~ctural Plan Review (.65% x Al) ~ ~ ~, ~ <br /> <br />(5) Zoning Sumharg¢, if applieabl~ (.05% x Al) <br /> <br />=$ __ <br /> <br />· i'o','^,, =* ~7.7. $~ <br /> <br />Signature of Applicant: __ <br />MC 15-73 Rev 1/9,5 <br /> <br />__Phone; <br /> <br /> <br />