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FOR CITY VALIDATION MARION COUNTY BUILDING INSPECTION[ FOR CITY USE ONLY <br />~ ~ . ~,/ COMMUNITY DEVELOPMENT CENTER <br /> Received By: /~'~r..nn~..r.,~ 285 Chu~h St. NE - Room 132 [Cjt~ S~b~k R~uir~m~ts: <br /> ' . ~ . il . · Salem, Oregop 973Q! <br />IZ°nms Va!?t°n: ' I <br /> <br /> COMPLETE ALL sEcT~O~ i ~gGH 4 . ~ <br /> <br />3, CO~CTOR INFO~TION -- pLEASE ~DICATE WHO IS DOING T~ WO~ <br /> <br /> ( ) [ am an AUTHORIZED REPRESENTATIVE of the property owner or conlractor. <br /> <br />4. FEE SCItEDULE <br /> <br />Ao <br /> <br />VALUATION - Based on square <br /> Gross Sq Pt ~/~' <br /> Garage Sq fl~ x 16.27 <br /> TOT^~S: /~ <br /> L PERMIT FEE: <br /> <br /> · Building ~ 185 per ~ ff <br /> EIcctd~l ~ .068 per sq <br /> Me~nical ~ .0~ per sq <br /> Plumbing ~ 070 per sq <br /> TOTAL $.345 PER SQ <br /> <br /> 2. PLAN ~VIEW FEE: <br /> <br />B. PERMIT FEES <br /> <br /> - ~---.:-' . ¥- /fY.d~ =, <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 is correct. Permits are non-Wansferra~e'~nd expire if)~ is not star~ed within 180 days of issuance or fwork s suspended for <br /> <br />Name of Apphcan, (Please Print): ' ~;~¢ hone: ~ <br /> <br /> <br />