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~ eceivedBy' /~'~ <br /> ~'~:Mng Vali~ati~ I <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> COMMUNITY DEVELOPMENT CENTER <br /> 285 Church St. NE - Room 132 <br /> Salem, Oregon 97301 <br /> 8:OOam-4:3Opm Phone 588-5147 <br /> 24 hr. Inspection Line 373-4427 <br /> FAX 588-7948 <br /> <br />FOR CITY USE ONLY <br /> <br /> ONE & TWO FAMILY DWELLING PERMIT APPLIC~T. IQN <br /> *Includes electrical, m~ <br />COMPLETE ALL SECTIONS, 1 THROUGH 4 <br /> <br /> ~New Single Family Dwellthg With Attached Garage <br /> ( ) New gingle Family Dwelling With Detached Garage MARION COUNTY <br /> ~ ~No~nplex BUILDINQ INSPEGTION <br /> No. Stories <br /> <br />2. LOCATION OF INSTALLATION <br /> <br /> Properly Owner ' ~ Mailing Address <br /> <br /> Prlvat¢ Weit ( ) Spring <br /> Acres <br /> <br />3. CONTRACTOR INFORMATION -- PLEASE INDICATE WHO IS DOING THE WORK <br /> <br />() <br /> <br />4. FEE SCHEDULE <br /> <br />Ao <br /> <br />VALUATION - Baaed on square footage: <br /> <br /> TOTALS: ~ = $ <br /> 1. PERMIT FEE: <br /> <br /> * Building ~ .185 per sq R <br /> Eleet~al ~ .068 per sq it <br /> <br /> Plumbing ~ .070 per sq ~t <br /> TOTAL $.345 PER SQ FT <br /> <br />l. Permit Fee (A-1) = $ <br />2. State Surcharge (5% of A-l) = $ ~ <br /> <br />5. lnvesgg~on Fee ($.345 per sq t) = $ <br />6. Rein~ction Fee $25.00 = $ <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 informally9~ 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 />lSO days. / ! <br />Name of Applicant (Please Print): ~{/~'/7, . i~ ~' ~ Phone: <br /> <br /> <br />