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MARION COUNTY BUILDING INSPECTION <br /> 220 High Street NE <br /> Salem, OR 97301 <br /> 8:00am-4:30pm Phone 588-5147 <br /> Code-A. Phone 588-7904 <br /> FAX 588-7948 <br /> <br />FO~QFFiC~E USE ONLY <br /> <br />COMPLETE ALL SECTIONS, 1 THROUGII 4 <br /> <br />1. Job Description <br /> <br />( tO/New Single Family Dwell[ag w/garage ( ~amge, atm.ehed <br /> <br />( ) New Single Family Dwelling w/o garage ( ) Garage, delached <br /> <br />~-~' or Rafter ( ) I No, Stories i l Dt;,aehed Garage Height; [ <br /> SqtareFzet: ]Sasoment: I Main Floor: /~2_O$: I Second Floor: IGarage: ¢/'~4~ I Other: <br /> <br />2. Location of Installation <br /> <br />........... Commuliy W~ll ( ) City ~,,f <br /> <br />3. Co~tractor I~ formatio,n <br />Proper~y Own~,t ~.,gt¢l~'R.~, ~ I M~lingAdd,'es~ <br /> ( ) I own, reside in, ~ will reside in the eomplc~d <br /> <br /> ( ) ~unders~ndthat~m~ctr~¢sterasaco~tm~n~n~act~if~iss~d~r~r~df~rsa~e~f~re~ru~mp~. <br /> ( ) I will bc my own general contra~or. <br /> <br />who is r*gistered with the Construction Coatx~tor's g~ard, I will immediately notify Marion County of the nanlu of thc contrae, or: <br /> <br />C°ntraet°r Business name & #: l& Mail/ngAddress:~t~ k le do ; Ct <br /> ( ) m a regi~tere ild*r OR die authorized representative ~a registered buildex. ' <br /> <br />4. Fee Schedule <br />A. blew One-and-Two Family Dw*lling Code <br /> <br /> {inlcude.s El, Me, PI) <br /> <br />(2) 5% State Surcharge (.05 x Al) <br /> <br />(3) Plan Review <br /> <br />(4) Zoning Surcharge ($15 if applicable) <br /> <br />$185.00 <br />_el, <br /> <br />(1) Driveway w/¢0rb @ $7.50 <br /> <br />(2) Driveway w/o curb @ $I7.00 <br /> <br />(3) Additional Plan Reviews or Addendurmq <br /> <br />(4) IIIveafigatlon Fee <br /> <br />(5) R*thspeetion Fee @ <br /> <br />(6) Other Innpeetions not listed ahoy* <br /> <br />.... x $40 = <br /> <br /> Site evaluations, septic, electrical, plumbing and m~chanica[ work require seperalo l;~rmita. Check with Marion County Building Inspection before subufithng Ibis application. <br />MC 15-80 Rev, 1/92 <br /> <br /> <br />