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03/29/96 14:04 8503 588 7948 <br /> <br />SABRE CONST. <br /> <br />~3OOl <br /> <br />IFOR CI, TY VALIDATION <br />R~c~ived By: __ <br />Zoning Validation: <br /> <br /> Date: <br /> <br />COMPLETE ALL SECTIONS. 1 THROUGH <br /> <br />1. JOB DESCRIF1XON I <br /> <br />RF~n~BNTIAL <br /> <br /> ( ) Addition ( ) Relocation <br /> ( ) Alteration ( ) Other <br /> ( ) Accessory <br /> <br />tcFOR CITY USE ONLY <br /> <br /> Ity Sethm:k Requkemenis: <br /> <br /> Franc ] Rmr: <br /> LeR Sid~: <br /> <br />Q 0 -anOOl <br /> <br />U~ of Strueture~ <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> COMMUNITY DEVELOPMff~NT CENTER <br /> ~5 Chumh St. NE - Room 132 <br /> Salem, Oregon 97301 <br /> 8:00nm.4~3Opm Phone 588-5147 <br /> 24 hr. Inspection Line S88-7904 <br /> FAX 588-79~8 <br /> <br /> BUILDING PERMIT APPLICATION <br /> <br /> COMMERCIAL <br /> <br /> ( ) Addition ~) New <br /> ( ) Alteration ( ) Sign <br /> ( ) Change of Occupancy ( ) Other <br /> <br />lis this a historical buildins? Yo~ - ~ <br /> <br />~,~p~ono.,Wo,k ~'~?/Ct~' P~: .~,~~o /.~ffff/z/-~/~G'~ <br />Energy P~sth: I No. Stories J No. or F-mploye~s: Existi nS - New- <br />Squa~ Foo'*~ -Basement: [ Main Floor: I S~cond Floor:. Garagc: <br /> <br />inn.Bedrooms: <br /> <br />[Or.h~ [ Heisht: <br /> <br />2. LOCATION OF INSTALLATION <br /> <br />Subdivision <br /> <br />Tax Acct. No. <br /> 7 7 <br /> <br />Space; <br /> <br />Mo~llo Home Park <br />Se~cn Township Range Zone <br /> Lot Depth Ac~s Irreg. Lot <br /> <br />Lot Width <br /> <br />Comer <br /> <br />Cross Strut <br /> <br />Block <br /> <br />Water Supply: <br />Prix'sm Well ( ) Spring ( ) <br />Communi~W~]i ( ) O, ty ( ) <br /> <br />3. CONTRACTOR INFORMATION -- PLEASE INDICATE WHO I5 DOING THE WORK <br /> <br /> I the PROPER'FY OWNER and rnslde in, or will rostde in the completed structure and will be own ~.aeml contracwr. [ understand that I must register construction <br />own, <br />my <br />contractor if sba stmcnire is sold or offered for sale before or upon compleiion. If I hire subcontractors, I will hire only subcontractors registered with the Conscm~ioo Contractors Board. <br />IfI change my mind and do hire s general contra,~tor who is relis~rnd with the Construction Conwacto.,3 Boa~d, [ will immediately notify Marion County of the name of Sba <br />( ) I am a CONTRACTOR registered with the S~ato of Oreson. <br />Business Name Registration No. <br />Msilin~ Address Phon~ <br />( ) I am an AUTHORIZED R~PRL~.NTATIVE o! the property owmr or contractor. <br />M~ilin~ Address Phon~ <br /> <br />VALUATION (See "Valuation Scbadutc" to de~rmi~n valuation based <br /> <br />on squaru footag~ of p£oj~c~.) Valuation: <br />(I) Permit Fee <br />(2) 5% State. Surcharge (.05 x Al') <br />(3) SImc~'al Plan R~vtcw (.6~% x Al) <br />(4) Fira & Lifo Safety Plan Review (.40% x Al) <br />(5) ZonJ=~ Surcharge. if applicable (.05% x Al) <br />(6) Seismic Surchar~o <br /> <br />MisceUaneou~ Fees <br /> (1) Additional Plan R~views or Addendums <br /> <br /> (2) Investi~tion Fee <br /> <br /> (3) Reinsp~ctton Fee · $23.00 <br /> <br /> (4) Other Inspections ~.ot listed above <br /> <br />-$ <br /> <br />I hereby conill/that the above information is con'ecu <br />Permits are non4ransfe~rable and expire if work is not started wi~i~l~ days of issuance or if work is suspended for 180 days. <br /> <br /> / <br /> <br /> <br />