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FOR CITY VALIDAT~ION <br />Receiv?By: <br />IZoning Validation: <br /> <br /> ONE & TWO FAMILY DWELLING pERMIT APPLICATION <br /> . *Includes electrical, mechanical, Plumbing fees <br />COMPLETE ALL sEcTIONS, 1 THROUGH 4 <br />1. JOB DESCRIPTION <br /> <br />MARION COUNTY BUILDING INSPECTION [ FOR CITY USE ONLY <br />COMMUNITY DEVELOPMENT CENTER [ ~ -- -- <br />285 Church St. NE - Room 132 [City Setback Requimmat~: <br /> $~!em, Oreg°n 9730!. I - , <br /> <br /> FAX 588-7948 I ' lc" I <br /> <br />(~gle Fatuity Dwelling With Attached Garage <br />( ) New Sifigle Fainiiy~DWelling With D~tached Garage <br /> <br />( ) New Duplex <br /> <br />BUiLDiNG INSPECTION <br /> <br />( ) Ci~ <br /> <br />4. FEE SCHEDULE <br /> <br />Ao <br /> <br />VALUATION r Based on squa~ footage: <br /> <br /> ~TAL $.345 PER SQ FT <br /> <br /> B. PEIOdlT FEES <br /> <br />, 2. StateSureharge(5%ofA-I) aS ~ <br /> <br /> 5. Investigation Fee ($.34~ I~' sq fi) = S <br /> fi. Reinspection F~e $25.00 - $ <br /> 7. Other insl~ction $4~.00/per hr (1 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 />I hereby certify that the above information i~ correct. Permits are non-transferrable and expire if work is not stmed within 180 days of issuance or if work is SUSlX~d~d for <br />180 days. <br /> <br /> ,.//v -Oa,e: <br />MC 15-80 Rev 1/96 y <br /> <br /> <br />