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MARION COUNTY BUILDING INSPECTION <br /> <br /> Salem, OR <br /> 8:00 am.4:30pm !~one [/l~147 <br /> <br /> MANUFACTURED STRUCTURE PLACJ~MENI <br />COMPLETE ALL SECTIONS, 1T~OUGH 4 PER~T APPLICATIO~RI0N <br />I. Job ~scri] ,Oon BUILDING <br /> <br />Re~identlal( ~" New(~''~ Rcplaccmmt( ) Garage ot Calgoa <br /> ( )Atmched <br />Cmmc~al( ) New( ) Rcp~ce~t( ) ( ) D~ta~ed <br /> <br />2. Location of Installation <br /> <br />3. Contractor Information <br /> <br />) I own, reside in, or will msidc in the ¢omple~,l structure, <br /> <br />) I understand that ! must register as a construction contractor ff the stmcmm is sold or offered for sale before or upon completion. <br /> <br />) I will be my own general contractor, <br /> <br />immediatclyn°dfyMarl°nC°umY°,fthenamc°fth¢°°ntract°r' ~/~2) Tt~ <br /> <br />Aumofi=d agcnt or leasee: [Ma~g Address: l, Phonc: <br />4. Fee Schedule <br /> <br />A. (1) Manufactured Home <br /> (~) State Fee <br /> <br /> (4) Zoning Surcharg~-0.~00 ffapplicable) <br /> <br />TOTAL: $~ <br /> <br />B. ( ) Mfg, d Structure S oragc Fcc <br /> @ $ 25.00 =__ <br />(2) Mfg.'d $tm~tu~ Storage Rcncwal @ %5.00 =__ <br />(3) Zoinng Surcharge (15.00 ff applicable) @ 15.00=__ <br /> <br />Other inspec6ons not listed <br />@ 40,00 pet hour (2 bout m~nlmum) <br /> <br />@ $60,00=__~ <br /> <br />@ $40.00 =___ <br />TOTAL = $ <br /> <br /> <br />