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IFOR CITY VALIDATION[ MARIONgOM~TY~Bv~U~IoopD~I~NGc~S~PECTION [ FOR CITY USE ONLY <br /> <br /> S~e~ ~g~ 97301 ' <br /> <br /> ~ 24 hr lns~on L~e 37 ' , ~' <br /> ONE & ~O FA~Y D~LL~GP~~J F~ ~/ <br /> *Inclu~ e~cal, mechan~a~bin~e~ ~ I ~ l i <br />CO~LE~ ~L SEC~ONS, 1 THROUGH 4 ~ V - 6 19 b"e <br /> <br />( ) New Single Family Dwelling With Attached Garage <br /> <br />( ) New Single Family Dwelling With Detached Garage <br />(~ew Duplex <br /> <br /> .......... ~,-- ~ ~ ~ ..... -~.'__).~ <br /> I ! I I <br /> <br />2. LOCATION OF ~ST~LA~ON ~~. ~ <br /> <br /> S~i~ [ ~t [ BI~ <br /> ~v~ Well ( ) Spdng <br /> <br />3. CONT~OR ~O~ON ~ PLEASE ~ICA~ WHO IS ~ING T~ WO~ <br /> <br />( ) I am thc PROPERTY OWNER and own, reside in, or will reside in the completed structure and will be my own general contractor. I understand that I must register as a construction <br />contractor if the stmem~ is sold or offered for sale before or upon completion. Ifl hire subcontractors, I will hire only subcontractors registered with the Construction Contractors Board. <br />IfI change my mind mci ~lo hire a general eonUaetor who is registered with the Construction Contractors Board, I will immediately notify Marion County of the name of the contractor. <br />~"/I am a CONTRACTOR registered with file State of Oregon. <br />Business Name Registration No. <br />( ) I am an AUTHORIZ~IB R~PR~SI/NTATIV~ of the property owner or contractor. <br />Name <br />qa~ ~i~t) <br />Mailing Address Phone <br /> <br />4. FEE SCHEDULE <br /> <br />VALUATION - Based on square footage: <br /> TOTALS:Gr°ssSqFt~x-. -.~__ 64.66 <br /> Garage Sq fl ~'~*t~: {~ x 16.27 <br /> <br /> 1. PI/RMTF <br /> GrussSqFt ~ x $.345/sqfl <br /> * Building (~ .185 per sq fi <br /> Electrical (~ .O68 per sq <br /> Mechanical (~ .022 per sq <br /> Plumbing ~ .070 per sq <br /> TOTAL $.345 PER SQ FT <br /> <br /> 2. PLAN REVIEW FEI/: <br /> <br />1. Permit Fee (A-I) <br /> <br />2. State Surcharge (5% of A-I) <br /> <br />3. Plan Review Fee (A-2) <br /> <br />5. Investigation Fee ($.345 per sq fl) <br /> <br />6. Reinspection Fee $25,00 <br /> <br />7. Other inspection $40.00/per hr (1 hr min.) <br /> <br />8. Overtime inspections $40.00/per hr (2 hr min.) <br /> <br /> tOTAL <br /> <br />Dwelling labels must be obtained nt 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 sta~d within 180 days of issuance or if work is suspended for <br />Name of Applicant (Please P~nt): ~'~ Phone: <br /> <br />MC 15-80 Rev 1/96 <br /> <br /> <br />