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OFRCE USE ONLY <br />Received by: <br />Date: <br /> <br />MARION COUN'rY BUILDING INSPECTION <br /> <br /> 'Salem, Off~Jon 97301 <br /> <br /> ~ITE #::. : ' :: '~:~rmit:No;''' ·: ' <br /> ~: ~AANIUI~ UUU~ <br /> <br />2~FOROWNERti~STALLA'IIQNS <br />Property Owner <br />Mailing Address ]' Phone <br />Clty/$tstelZIp <br /> <br />The instaIMflon ia being made on property I own which la not Jntended for sale, <br /> <br />3. PLAN REVIEW SECIION <br /> Check appropriate item and antsr fee in Section 5B. <br /> <br />__ Connected Load over 200 amps (except single family dwellings) <br />.... Building system over 200 amps (except single family dwellings) <br /> System over 600 volts <br />__ Building over 2 sl=i'ies <br />__ Building over 10.000 ~;tuare feet <br />__ Occupant Icad over 300 pemons <br />__ Manufactured Dwelling Parld~n Park <br /> Hazardous Locat~ns <br /> <br />Submit 2 sets of plans with any of the above. <br />Temporary construc'~on services do not apply. <br /> <br />4. FEE SCHEDULE (Complete and emer total in A~ below) <br /> <br />Number ~ thspectlon~ per permit eltewe~ <br /> / <br /> <br />Multi-Femlly per ~lthg unit <br /> <br /> 15~.fl. or~ ~ $ ~, -- 4 <br /> ~ a~l~0 ~. fi. ~ pe~on <br /> <br /> O~ll~ ~ er f~r <br /> <br /> ~r ~ ~ or 1~ velm (S~ 4B) <br /> <br /> Onecimuit ~ $ ~. 2 <br /> <br />E~h~d'l~n=imui~or~on ~ $ 15. ~ 2 <br />(~ ~ F~ ~t ~) <br /> <br /> Ea~ s~n ~ outline I~h~ng <br /> S~nN clair(s) of a li~ e~y <br /> ~1, a~omfion or ex~n~on ~ $ ~, __ 2 <br /> <br /> ~ the ~l~e In any of <br /> · e ~e. per In~8on <br /> <br /> P~kof 10 ~els ~ SS,~ e~h <br /> <br />~ O~er <br /> (~ ~i~ ~y ~il~ng.~i~l) <br /> <br />A~. Enter total of fees from Seo. <br /> <br />B. En~ ~% ~ llne A~ ~ P~ R~ <br />(~ 3). if ~uir~ $ <br />C. I~s~0~ F~ (E ~uimd) <br />D. ~n~n F~ ~.00) <br /> <br /> TOTAL A~UNT DUE <br /> <br /> . <br /> <br /> <br />