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MARION COUNTY BUILDING INSPECTION <br /> 220 High Street NE <br /> Salem, OR 97301 <br /> <br /> $:00mm - 4;309m Phone. S&ll-5147. <br /> <br /> BUILDING PERMIT A~I~LICATION <br /> 9 <br /> <br />FoR OFFICE USE ONLY <br /> <br />City Setback Requlremems: <br /> <br />1, Job Description <br /> <br />2. Loeationoflnstanaflon ,ff~3vs'~/ d~/¢ ~'?xr~.t~:C',, <br /> <br />Contractor Information <br /> <br />( ) I own ~sMe ~, ~ ~ reside ~ ~e ~m~e~d stratum, <br />( ) I ~nflef~nd ~at I must ~s~r as a ~xtmefim con~c~ ~ ~e ~ is sold or offered for sale ~fog <br /> <br />with a contractor who is mglstered withe Construction Contm¢ofs BoalB, and ~1 ~eflia~ly n~y Mafi~ County of ~e nme ~ ~e c~[tacmr. <br /> <br />Fee Schedule <br /> <br />A, VALUATION(See '*Valuation Schedule" <br /> to determine valuation based on <br /> ~quam footage.) <br /> (1) l'¢rmit Fee <br /> (2) 5% State SurchaIg~ 605 x Al) <br /> <br /> (3) Structural Plan Review (.65% x Al) <br /> (4) Fire & Life Safety Plan Review (,40% x Al) <br /> (5) 7~mi~~Ai7 <br /> <br />Miscellaneous Fees <br /> <br />(1) Driveway w/curb@ $750 <br />(2) Driveway w/o curb @ $17.00 <br /> <br />(~) Si~e Plan Review (commercial Only) <br />(4) Addirional Plan Reviews or Addenduma <br />(5) Invc*figarion Fee <br /> <br />(6) Reimpeefion Fee@ $25.00 <br /> <br />G) Otherln~pections)tot listed above <br /> <br />I hereby certify ~lat the above infom~alion is corn:et and that I have read and understand the Information Notice to Property Owners about Conztmction ResponsibiJities on the <br /> MC 15-73 Rev, 11/91 <br /> <br /> <br />