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MARION COUNTY BUIL]DING INSPECTION <br /> 220 Higl~ Stro.,t NE <br /> Salem, OR 9~301 <br /> 8;00am-4:30pm Phon0 588-5147 <br /> Code- A- P~n~ 5g$-7904 <br /> FAX 588-794g <br /> <br />ONE & TWO FAMILY DWELLING PERMIT APPLICATION <br /> <br />COMPLETE ALL SECTIONS, I THROUGII 4 <br /> <br />1. Job Description <br /> <br />( ) ..~ew :ingle Family Dwelling w/ga:ag& ( ) Garage, athached <br />( wVNew Single Family Dwelling w/o garage ( ) Garage, detached <br /> <br />'lYuss< ) Ot Rafter( ) <br /> <br />IOther: <br /> <br />Wa~r Supply; <br />PdvatcWell ( ) Spring ( ) <br />CommuaityWg]l( ) City ( ) <br /> <br />3. Contractor hfformation <br /> <br />Property Owner [ Mailing Ada:ess I Phone No. <br /> <br />If I hire suN. onlraetors, t will [tire only mbcomra~tors registered with ~he Conslrtlc~ion Contra~ots Beard. If I change my mind and do hire a general <br /> <br />Con~ractor Busln*ss nam,;, & Ih ] Mailing Address: ] Phone: <br /> <br /> ( ) I am a registered builder OR the authori;,.0d representative of a registered builder. <br />Archi,net name: ]Mailing Address: I.Ph°ne:. -,~ '~Z <br /> <br />4. Fee Schedule <br /> <br />(1) Driveway w,%mb ¢, $7.50 <br /> <br />(l) Driveway win crab ~, SI'L00 <br /> <br />(3) Additional Plan Reviows or Add~/~dum.q <br />(4) lnve.qfigafion Fee <br /> <br />($) Reinnpeehon Fee @ $25.00 <br /> <br />(6) Other In~peetionn not list*d ;~bov, <br /> <br />.... x$40= <br /> <br /> <br />