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De~:_ <br /> <br /> 22O High ! <br />~alern, Oregon 97301, <br /> <br />PECTION <br /> <br /> - Addition: [] <br />Commerclal~ Relocation E <br /> <br />· Residential <br /> New constructi~) <br /> <br />Re, ocatedRes dance (each,fixture) -- <br />CommemJ~l <br />N~ Con~uctio~eac~tu~) <br />Alteratio~ (each fixture) <br /> <br />NO. <br /> <br />AMOUNT <br /> $20,00 <br /> <br />9.00 <br /> <br />9,00 <br /> <br />'~~mof <br />Additional 100 feet <br /> <br />15,00 <br /> <br /> ~nd Building Official)- <br />On-Site <br /> Technical <br /> Review (apply et Marion County only. ,) _ <br /> <br />Please return COMPLETE APPL CATION <br />with the indicated fee. <br /> <br />~I~'S TAT E SURCHARGE <br />PLAN:'REVIEW.F~E <br />INvEsT GAT ON FEE <br />FLEET SURCHARGE <br />f,~_~ 'CITY FEE <br />'TOTAL <br /> <br />( ) lamaregJe~redbu~lderOR( )theauthodzedmpmsentative~ 51 <br />(~) The wo~ wi ~ oe oe~rm~ ~ a mgiate~d ~ullder, <br /> <br />MC lS-45 <br />Rev. 12/87 <br /> <br />$ ID~ <br /> <br /> <br />