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MARION COUNTY BUILDING INSPECTION <br />220 High Street NE <br /> Salem, OR 97301 <br /> <br /> I 8;00am-4:30pm Phone 588-5147 <br /> j,? ,/ Code-A-Phone 588-7904 <br /> ~AX 5811-7948 <br /> <br /> ONE & TWO FAMILY DWELLING PERMIT APPLICATION <br />COMPI.ETE ALL SECTIONS, 1 THROUGII 4 ~ <br />1. Sob Description <br /> <br />(~f~New Single Family Dwelling w/garag~ <br />( ) New Single Family Dwelling w/o garage <br /> <br />( ~Garage, attaches1 <br />( ) Garage, detached <br /> <br />/ <br /> <br />MARION COUNIY <br />BUILDING INSPECIiON <br /> <br /> ) [ NO, Stories / 1 Detached Gi~rag¢ Height: , No. Bedrooms: <br />2. Locafionofl.s~llat~on ~( ~ ~tT~l <br /> <br />3. Contractor Information <br /> <br /> ( ) I own, reside in, or ~dl reside in the eomplm~d structure, <br /> <br />If I hire subcontraclors, I will hire only subcontractors registered with the Construction Conlractors Bo02d, If I dmnge my mind and do lfire a general contractor <br />who is registexed wi,~ the Constmction~Coj~tractor's..~, Board I will immsd ~a ~)g ~otify Mar on County of the name of the contracor: <br /> <br /> ( ) I am a registered builder O~ ~fllori~d rc~ntafive of a rcois~red b~lder <br /> <br />4. Fee Schedule <br /> <br />A. New Oho-and-Two Family Dwelling Code <br /> (inledd~ gl, M~, PI) <br /> <br /> (2) 5% State Surcharge (,05 x Al) <br /> <br /> (3) Plan Review <br /> <br /> $I85,00 <br /> <br />: <br /> <br />B, Miaeellarleoas Fees <br /> (1) Driveway w/curb @ $7,50 <br /> <br /> (2) Driveway w/o curb {0 $17,00 <br /> <br /> (3) Additional Plan R~views or Addendums <br /> <br /> (4) II)vesligafion Fee <br /> <br /> (5) Reinspeetion Fee @ $25.00 <br /> <br /> (6) Other Inspections not listed ,above <br /> <br />I hereby c,cmg.!t!a~d~e ,d,ove information tq correct and that I have read and understand the InforiImtion Notice to Property Owners about Con~ a,¢fio Rcspons b e~ o ti c <br /> <br /> <br />