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FOR OFFICE USE ONLY <br /> by:.. <br />Zoning Validation ..... <br />Oat& <br /> <br />MARION COUNTY B' <br /> <br /> 220 Ri <br /> Salem <br /> <br /> FAX; <br /> <br />JiLDING INSPECTION <br /> <br /> Slreet NE <br /> 97301 <br /> !Yn one 588-5147 <br /> 58g-7904 <br />g$-7948 <br /> <br /> MANUFACTURED ST~ UCTURE PLACEMENT <br /> PERMIT Al PLICATION <br />COMPLET~ ALL SECTIONS, 1 THROUGH 4 <br /> <br />2. Location of Installation <br /> <br />Su~vism L~ I gl~ Urban Growth goundau? <br /> <br />t.awida ~S, L~pth ]00 Xc~s ~eg.~t~ Comer ~g pdva~Wall < ) Spricg ( <br /> ,, Commu~ty Well ( } City <br /> <br />3, Conlxactor Information <br /> <br />( ) I o~, reside ~. ~ ~t reside ~ ~ cm~e~d s~u~. <br />(~) I un&rsmnd ~at I must ~ster as a ¢~glmafi~ c~c~r ff ~ s~ ~ sold or ~gd for sale befo~ or u~ c~plefim. <br />(~) I will be my <br /> <br /> If I him subcontractors, I will hire only subcontractors registered with the Cons~rulaitm Coatractor~ Board. <br /> If I change my mind nod do him a general contractor. I wdl[ contract with a c-ontrattor who is mgist¢red with thc ¢ons~mctloB Contractor's Board, and will <br /> immediately notily Marion County of thc name of the contractor. ~//J <br /> <br />- (/") I am a regismmd builder OR the authorized mpres6~t~tive of s mgist~,mdlbu~ld~. <br /> Authori~'gd agent of l~ame: 1~ ~. , Ma~g Address: ~ .~ <br /> <br /> 2040 = <br /> <br />TOTAL: <br /> <br />4, Fee Schedule <br />A. (1) ManuCactured Home <br /> <br /> (2) S~ate Fee <br /> (3) S~e Surcb~e <br /> <br />g. (1) Mfg.'d 8~m~mm Storage <br /> (2) ~g,'d S~cm~ Sw~e R~new~ <br /> <br /> O) ~ning Sumha~e (15,~ffa~cable) <br /> <br />@ $25,00= <br />@ 25,00 =. <br />@ 15.00=__ :; <br /> <br />C. Additional~sp~ctloa @ $60,00 -' <br /> <br />D. Investigation Fee <br /> <br />E. Oth~' inspections not listed <br /> @ 40.00 l~r hour (2 hour minimum) <br /> <br />@ $40,00 <br /> <br />TOTAL= <br /> <br /> <br />