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CITY VA]LIDATION NG INSPECTION I FOR CITY USE ONLY <br /> ~ · · .~ COMMUNITY DEVELOPMENT CENTER I <br /> ed By - ~d/~ 285 Church St. NE- Room 132 City S~tback R~quirem~n s ~ <br /> ~ . .---~'~''"ff~ Salem, Oregon 97301 I ~'.~/ I <br />IZoningValidation: ~ g:00am-4:30pm Phone 5gg-5147 IVro~t: ~r I~ar: <br /> · ~ ~ 24 hr. Inspection Line 373-4427 Lefi Side. ,/ Ri t Side' <br /> <br /> ONE & TWO FAMR,Y DWELLING PERMIT APPLICATION <br /> *Includes electrical, mechanical, plumbing fees <br /> <br />COMPLETE ALL SECTIONS, 1 THROUGH 4 <br />1. JOB DESCRIPTION q7-a3'o?q <br /> ~With Attached Garage <br /> ( ) New Single Family Dwelling With Detached Garage <br /> ( ) New Duplex <br /> <br />Energy path: ~ ~e Height~ <br /> 1 M~n Floor- JJ~ l S~ond F]oor= <br /> <br />MARION COUNTY <br /> <br />BUILDINIG~__S~ION <br /> <br />2. LOCATION OF INSTALLATION ,~7~O _,~'~/_ '7~ M¢~/_~" <br />City <br /> <br /> Block <br /> <br /> C0mm~i~ Well ( ) Ci~ ~ <br /> <br />3. CONT~CTOR ~O~TION ~ PLEBE INDICA~ WHO IS DOING THE WO~ <br /> <br />( ) I am an AUTHORIZED REPRESENTATIVE or the property owner or conwactor. ~,~:~).,.x~ <br /> Name <br /> <br />Phor~ <br /> <br />4. FEE SCHEDULE <br /> <br />1. PERMlT FEE: <br /> <br /> TOTAL $.345 PER SQ FT' <br />2. PLAN REVIEW FEE: <br /> <br />3. Plan Review Fee (A-2) <br /> <br />Investigation Fcc ($.345 per sq fi) <br /> <br />Reinspcction Fee $25.00 <br /> <br />Other !nspection $40.00/per hr (1 hr mi~.) <br />Owrtim~ inspections $40.00/per hr (2 hr min.) <br /> <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 />!.h~e~b. y certify that the above informa, on is correct. Permits are non~gl~Sferrable and expire it* work is not started within 180 days of issuance or if work is suspended for <br /> <br />S~gnature of Apphcant: ~ Date: ~ - <br />MC 15-80 Rev 1/96 <br /> <br /> <br />