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DWELL - 1334725
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DWELL - 1334725
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Last modified
1/31/2013 3:52:47 PM
Creation date
12/3/2003 12:02:17 PM
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Permits
Permit Address
374 SHAMROCK ST
Permit City
AUMSVILLE
Permit Number
555-96-00937
Parcel Number
082W25DA05700
Permit Type
DWELL
Permit Doc Type
Permit Document
Status
Ready to Film
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FOR CITY VALIDATION MARION COUNTY BUILDING INSPECTION FOR CITY USE ONLY <br />I ,, __ COMMUNITY DEVELOPMENT CENTER -- -- <br />IReceivedBy: ~_/3 ~.4~.t.// 285C_hu, rchS~t. NE-~R~o~o,rn132 ~, , City Setback Requirements: <br />I ~ ff. 5mem, uregon <br />Izbning Validation: ~'.~- 8:00am-4:30pm Phone 588-5147 Front: <br /> <br /> 4- 24 hr. Inspection Line 588-7904 Left Side' <br />I ....... - - ~ ~' FAX 5~9~48 ' <br /> <br /> ONE & TWO FAMILY DWE~tgl~~IT APPLICATION <br /> *Includes electrical, ~-~a{~?fi~es <br /> <br />1. JOB DESCRIPTION <br /> <br /> ( ) New Single Family Dwelling With Attached Garage - ~m' <br /> ( )NewSingleFamilyDwellingWithDetachedGarage ~{J/t"~O~Ol~,.CO[,~ 0 ~m~r~,/~,.~/el~ F//9,/Ft .. <br /> <br /> No S~o~ ~a~be~ ~a~ ~ ~. ~ cUD0~ ~o ~oom~ <br /> Squ~F~t: B~ement:: [M~nH~r: Z]O~ ]SecondHoor: Garage: ~ O~er: <br /> <br />2. LOCATION OF INSTALLATION <br /> <br />Property Owner ~/~f,~ R, Mar sAo// I U--~li~gXd~ss'~n~ t~. ~7~ I <br /> <br />Cross S~t ~ ~ ~ ~eP. . Tax Acct. No. ~/~_ X~ <br />Su~ivision ~3amroa~ E~~s ~o~ ~7 Bl~k <br /> <br />Section Township R~ge Zone ~ Map Water Supply: <br /> ~va~ W~ll ( ) Spring <br />~t Wid~ /~ t ~t Dep~ /~O ' Acres I~eg. ~t Comer A~O Country Well ( ) Ci~ <br /> <br />3. CONTRACTOR INFORMATION ~ PLEASE INDICATE WHO IS DOING THE WORK <br /> <br />I am the PROPERTY OWNER and own, reside in, or will reside in the completed structure and will be own general contractor. I understand that I must register as a construction <br />my <br />contractor if the structure is sold or offered for sale before or upon completion. If I hire subcontractors, I will hire only subcontractors registered with the Construction Contractors Board. <br />If I change my mind and do hire a general contractor who is registered with the Construction Contractors Board, I will immediately notify Marion County of the name of the contractor. <br />I CONTRACTOR with the State of <br />am <br />a <br />registered <br />Oregon. <br />Business Name M~ ~,.,~ h O.. // ~'/O~,~ ~,n~ ~ ~ ~ Registration No. <br />(please print, q/~--a 74 <br />MailingAddre~g~.,q4 ~~O~ /~//'///~. ~'~', , 7~/~A~ge t~, q73qZ <br />I am an AUTHORIZED REPRESENTATIVE of the property owner or contractor. <br />Name <br />(please print) <br />Mailing Address Phone <br /> <br />4. FEE SCHEDULE <br /> <br /> B. <br /> <br />VALUATION: <br /> GrossSqFt o~(.e~' x 64.66 = $ <br /> <br /> 1. PERMIT FEE: . 8~ <br /> Gross Sq F, &a qG ~f~ , ~/~. ~ 7 <br /> * Buil~ng ~ .17~ ~r sq ft <br /> Elecffic~ ~ .0~ per sq ft <br /> Mech~ic~ ~ .02~ per sq ft <br /> Plumbing ~ .0650 per sq ft <br /> <br /> TOTAL $.315 PER SQ ~ <br /> <br />2. PLAN REVIEW FEE: I alOO <br /> GrossSqrt o~{ag/~' ~7~sqft $ $i7,52~ <br /> <br /> PERMIT FEES <br />1. Permit Fee (A-l) =$ <br />2. State Surcharge (5% of A-l) = $ <br />3. ~ Plan Review Fee (A-2) <br />5. Investigation F~ ($.41 ~r sq ft) = $ <br />6. Reinspection F~ $25.~ = $ <br />7. O~er ins~ction $40.~/~r ~ (1 hr ~n.) = $ <br />8. Ove~ime inspections ~0.ffi/~r ~ (2 ~ ~n.) = $ <br />9. Foofin~oun~tion Only $25.~ - County Use OMy = $ <br /> TOTAL ~ ~ =$ <br /> <br />Dwelling labels must be obtained at Marion County Building Inspection and must be placed at the jobsite prior to inspection for plumbing, electrical and <br />mechanical work. Contact Marion County for instructions. <br /> <br />I hereby certify that the above information is correct. Permits are non-transferrable and expire if work is not started within 180 days of issuance or if work is suspended for <br />180days. /'~1 · ~ AJ / // <br />Name of Applicant (Please Print): L_.~2/I~/~g'] K- /i/[a~e~/tt Phone: <br /> <br />MC 15-80 Rev 1/95 <br /> <br /> <br />
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