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IFgR OFVIC~U. SE?JSLYI MARION COUNTY BUILDING INSPECTION ~ USE ONLY <br />ZoningValid~tion: ~/ SMem, OR97301 ~ ~ U ~ ~ ~i~'~K~ ~R~,~: y/ , <br /> 8 ~ - 4 3 ~e 588- . . / <br /> <br /> BU~D~G PERM~ APPLICATION <br /> CO~La~ ~L SECTIONS, 1 T~OUGH 4 ~aal0~ C00~;Y <br /> 1. Job Description BUILDING iNSPECTION <br /> <br />RESID .~qTIAL COIVIMBR~AL ( )New U,e of Structure: <br />() Addltlon ()Relocation ( )ad0ition ()Sign ~/~- <br /> ( ) Alteratic~o ( )Demolition ( )Alteration ( ) Demolition/'P'~L~CJ <br /> (~cce~5, ( )Other ( )Chang~ofOccupancy ( )Other <br /> <br />Tmss([/)~ or Rafte[,.!, ) ] Ne. Stories / lO¢¢tqNlntLoadorNmnb~rofl~mployees , No. Bedrooms: <br /> <br />2. Locatioo of Installation '~c~'~n~-~, ~ G 73.:5- <br /> <br /> Contractor Information <br />P_mpe_n~ /~ ~ I Mai/lng Addt,ss ~CL~ ~_.~ ~hone No: <br /> ) I own, reside m. or Mil reside in the eomplete~'stmcture. <br /> ) I understand that I must register as a construction contractor if the structure is sold or offered for sale before or upon completion, <br /> (¢~/I will be my own general contractor, <br /> <br />If I him subcontractors, I will him only subcontractors registered with the Construction Contractors BeaM. If I change my mind and do hire a genera I contractor, I will co~tract <br />with a contractor who is mglstered withe Construction Contractors Boat~. and will immediately no[fly Mar/on County of the name of the cmtracton <br /> <br /> ( ) I am a registered builder OR the aatho~-,ed representative of a registered builder. <br /> <br />Archi~¢t name: [ Mailing Address: l Phone; <br />4. Fee Schedule <br />I A, VALUATION (Sec "Valuation Schedule" B. Miscellaneous Fees <br /> <br />square footage,) <br />(1) Permit Fcc <br /> <br />(2) 5% State Surcharge (.05 x Al) <br /> <br />(3) Slractural Plan Review (.65% x Al) <br />(4) 1"ire & Life Safety Plan Review (.40% x Al) <br /> <br />Valuatlom $ 3~-~ <br /> <br />(1) Driveway w/curb @ $7.50 <br /> <br />(2) Driveway w/o curb @ $17.00 <br /> <br />O) Site Plan Review (commercial only) @ $79.00 <br /> <br />(4) Additional Plan Renews or Addcndmns <br /> <br />(5) Investigation F%e <br /> <br />(6) Rethspoetion Fee @ $25.00 <br /> <br />(7) OLhcr Insj~ctioas no; lis~ed above <br /> <br /> <br />