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PERMITS ARE NON. TRANSFERABLE AND EXPIRE IF WORR <br />IS NOT STARTED WITHIN 180 DAYS OF ISSUANCE OR IF <br />WORK IS SUSPENDED FOR 180 DAYS. <br /> <br />2A. CONTRACTOR INFORMATION <br /> <br />MailingAddr ss: 11/)7 flra.'O at <br /> <br />Property Owne~. (please print) <br />Mailing Address: <br />City: State: Zip: <br /> <br />I am the PROPERTY OWNER and own, reside in, or will reside in <br />the completed structure and will be my own general contractor. 1 <br />understarwl that I must register as a conMrucllon contractor if the <br />structure is sold or offered for sale before or upon completion, lf l <br />hire subcontractors, I will hire only subcontractors registered with <br />the Construction Contractors Board. If I change my mind and do <br />hire a general contractor who is registered with the Construction <br />Contractors Boar I will immediately notify Marion County of the <br />name of the contracto~ <br /> <br />Agent's Signature: <br /> <br />3. PLAN REVIEW SECTION <br /> <br /> Marion County does not require a plan review, We will provide plan <br /> review service if you complete Section 5B and submit two (2) sets of <br /> plans and specifications with this app ication. <br /> <br />MC 1545 R~v 9/98 <br /> <br />MARION COUNTY BUILDING INSPECTION <br />3150 Lancaster Dr. NE - Suite C <br /> <br /> ~/~ Salem, Oregon 97305 <br /> 24 HR Inspection Line 373-4427 FAX 588-7948 <br /> 7//) <br /> ~g/g~IEDULE (complete and enter ~ In 5- I bdo ) <br /> <br /> ~w~AL ( ) COMMERCIAL ( ) GAS <br /> ( ) ADD1TION ( ) ALTERATION <br /> <br />lqxmr~s (New ! Alteration) <br />Ama Drain <br />Backflow P~vention Device <br />Bathtub <br />Bidet <br />Catch Basin <br />Clothes Washer <br />D~ntal Unit <br />Cuspidor <br />Drinking Fountain <br /> <br />Lawn Vacuum Breaher ~~ / ,x <br />Wa~r lAn~ <br /> <br /> ( ) EL~CI~C <br /> <br /> ( ) RELOCATION <br /> <br />/ x :, <br /> <br /> $730 =$ <br /> $7.~=s 7,-~0~ 1 <br />$10.00 =$__ <br /> <br />$25.00 <br />$16.00 <br />$30.00 <br />$20,00 <br /> <br />$35.00 = $ -- <br />$16.00 = $ -- <br />$35.00 = $__ <br />$2o.oo = $__ <br /> <br />$35.00 = $ <br />$16.00 = $ -- <br />$35.00 = $__ <br />$20.00 = $ -- <br /> <br />MinorlnztallationLahels -- x $10.00=$__ <br />Pack of 10 labels ~ $10.00 ~L <br />sold only to Plumbing con~) <br /> <br />Dwelling Permit Labels #of Lahels __~ $ N/C <br />(For New Single Family Dwellings On]y) <br /> <br />Om~woFlanllyDwdlingFe~:SquamFeat: -- x $ .09=$__ <br />Othe~ (as required by the Building Official) $ -- <br /> <br />BASE FEE A~tsegs~l on ALL APPLICATIONS: <br />(Exception: Water/Sewer Line Applications w/no fixtures) <br /> <br /> Al. Enter total of f~es from Section #4 <br /> A2. Add Stere Surcharge (.05% x Al + Base Fee) <br /> <br /> SUBTOTAL <br /> '. Enter 30% of ~ A1 for elan Review /f~ <br /> <br /> D. R~iml~Ction F~ ($50.00) -- ! <br /> E. Additional Plan R,view ($62.50the, <br /> <br /> {$6230/ia'. minimm~ on~ hoar) <br /> <br /> ($62.50/hr, minimum two hours) <br /> <br /> <br />