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Received By: <br /> <br />Date: <br /> <br /> Please complete all Sections, I through 5 <br /> <br />1. LOCATION OF INSTALLATION <br /> <br /> PROPERTY OWNER <br /> <br />PERMITS ARE NON-TRANSFERABLE AND EXPIRE IF WORK IS NOT ] <br /> STARTED WITHIN 180 DAYS OF ISSUANCE OR IF <br /> I <br /> WORK IS SUSPENDED FOR lS0 DAYS. <br /> <br />2A. CONTRACTOR INSTALLATION ONLY <br /> <br />2B. FOR OWNER INSTALLATIONS <br /> <br />Propeay Owner (please print) <br /> <br />Mailing Address <br /> <br />City, State, Zip <br /> <br />3. PLAN REVIEW SECTION <br /> <br />Marion County does not require a plan review. <br />We will provide plan review service if you complete <br />Section 5B and submit two (2) sets of plans and <br />specifications with this application. <br /> <br /> MARION COUNTY <br />BUILDING INSPECTION DIVISION <br />3150 Lancaster Dr. NE - Suite C <br /> Salem, Oregon 97305-1398 <br /> <br /> 24 HR lnsgecfion Line 373-4427 <br /> Office: phone 5~8-$147 8:00am - 4:30pm <br /> FAX 588-7948 <br /> <br />4. FEE SCHEDULE (Complete and enter total in Al below) <br /> $15.00 <br /> <br />$2.00 <br /> <br />5. FEES <br /> Al, Enter total of fees from Sec. <br /> A2. Add 5% surchaeg¢ (.05 x Al) <br /> <br /> B, Enter 23~ of line A1 for P{ <br /> (Sec. 3), if required <br /> C. Investigation Fee ' ' <br /> <br />MC 15-34 7/97 <br /> <br /> <br />