PLBG - 1615864 - Laserfiche WebLink

Home Browse Search

Bt omG mSPEC ON ' . , 3150 L~caster Dr. NE - Suite C : R~eived By: ~ Date: ~~ S~e~ ~egon 97305 ~ ~ By: ~ Ci~:~ 8:~ - 4:3~m 24 ~ ~s~ion Line 373~27 F~ 588-7948 ~, R~eipt ~: ...................................... I IC~CI V ~ I~L~mG ~E~T ~LICA~ON ~ ~ 4. ~ sc~ ~m ~ ~t~ t~ I~ s-n~ ~eco~tea~Sec~,lth~ughS.~L ~~ ~ ~ ~s~ ~ ~o~ ~ans < ~IC ~N GOU~ ( )~ ( )~DmON ( )~ON ( )~L~A~ON ~.~cn~onovms~nLLnXm~ ~t~1~ IN~ I~.~n~ta~.o.~ ~. o~. Parcel ID: /30 city: DcCt otT zip: Project Description: PERMITS ARE NON-TRANSFERABLE AND EXPIRE IF WORK IS NOT STARTED WITHIN 180 DAYS OF ISSUANCE OR IF WORK IS SUSPENDED FOR 180 DAY& 2A. CONTRACTOR INFORMATION Con,actors Board RegismUlon Number: Contractor's Signature: 2B. FOR OWNER INSTALLATION Property Owner: (please ptqnt) I Mailing Address: City: State: Zip: I am the PROPERTY OWNER and own, reside in, or will reside in the completed structure and will he my own general contractor 1 understand that I must register as a construction contractor if the structure is sold or offered for sale before or upon completion, lf l hire subcontractors, I will hire only subcontractors registered with the Construction Contractors Board. If l change my mind and do hire a general contractor who is registered with the Construction Contractors Board, I will tmmediately not~fy Marion County of the name of the contractor. Owner's Signature: Agent's Signature: 3. PLAN REVI~W SECTION Marion County dces not require a plan review. We will provide plan review service if you complete Section 5B and submit two (2) sets of plans and specifications with this application, MC 1545 Rev 9/98 Residential: First 100 ft., or fraction thoreof ~.lJ x For ca addnl 100 feet x Residential: Fi~t 100 ~.. or fi'action thereof ~ x For ca addni 100 R, up to 500 fx x Commercial: F~rat 100 fL, or fraction thereof -- x For ea addnl 100 feet x I I $15.00--$ bo? 4 $7.50 = $ -- $7,50=$__1 $10.00 -- $ -- $25.00=$ ,r..--~t 2 $16.00 = $ -- $30.00 = $__ $20.00 = $__ $16.00 = $__ $35.00 = $ -- $20.00 = $__ $35.00= $__2 $16.00= $__ $35.00= $__ $20.00=$__ MinorlnstallaflonLahols __ x $10.00=$ Pack of 10 labels @ $10.00 each, sold only to Plumbing contra~to~) One/TwoFamilyDwellingFee:Squan:Feat: -- x $ .09=$__ N/C 5. FEES BASE FEE Assessed on ALL APPLICATIONS: (Exception: Wa~'/Sewer Line Applications wino fixtures) Al. Enter toad of fees from Section A2. Add State Surchaege (.05% x A1 + Ba~e Fee) SUBTOTAL B. Enter 30% of line Al for Plan Review C. Investigation Fee (if reqalred) D. ReinslaeCtion Fee ($50,00) E. Additional Plan Review ($62,50thr, minimum one-half hour) E Inspection for which no fee is specifically indicated, ($62.50/hr, minimum one hour) G. Inspection Outside Normal Business Hours, Ot'~ ($62.50/hr, minimum two hours) TOTAL AMOUNT DUE $ 25.00 $ ' $ lC~.°~ $__ $__ $__ $__ $__