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o.mCE ? <br /> <br />| Zoning <br /> <br />MARION COUNTY BUILDING INSPECTION <br />220 High Street NE <br /> Salem, OR 97301 <br /> 8:00am.4:30pm Phone 58g-5147 <br /> Code-A-Phone 588-7904 <br /> FAX 588-7948 <br /> <br />1. ,lob Description <br /> <br />(~) New Single Fmnily Dwelling w/garagt~ ( ~Garage, attached <br /> <br />FOR OFFICE USE ONLY <br /> <br />( ) New Single Family Dwelling w/o garage ( ) Garage, detached <br /> <br />Lift Side.: ~ · Right Side: <br /> <br />Tress ( ~ or Rafter ( ) I NO. Stories t [Detached Garage Height: No. Iledroom_q: J <br />Squ~*~,: u~,~=~t: Iu~"~°': /.3//'""'] Se=o~dnoor: [ a~ge: ~ / .....5a,,r: <br /> <br />2. Location of Installation <br /> <br />$obAddiess ~.. ~ TaxAcet, No, ~/..~-~A~ CrmaStreet ~//~)/¢~' <br /> <br />Se~Jon ~ To~c~ic, ~ Range ~ ~ Zone ~ ~ Map Water Su~ly: <br /> Pfiv~,W~ll ( ) Spring <br />~Widlh ~ / normal, /~a,~ Acres ~eg.~t YeS Comer ~0 CommunityWell( ) CJly <br /> <br />3. Contractor Infornmtion <br /> <br /> ) I own, reside in, or will r,side ia the completed awaemre. <br /> <br /> ) ~u~der$tandthat~mustregisterm~a~structi~c~tra¢ta-ifthes~mr¢is~d~f~*redf~rsa~ebefc~e~rup~n~mp~eti~n~ <br /> ) I will b~ my own general <br /> <br />v7 <br /> <br /> 4. Fee Schedule <br />! A. New One-and-Two FaroJly Dwelling Code <br /> (inlcttd~ El, ~¢, PI) <br /> <br />(1) Gro,qs Sq. Ft. <br /> <br />(2) 5% State Surcharge (,05 x Al) <br /> <br />(3) Plan Review <br /> <br />(4) Zoning Surchaege ($15 if applicable) <br /> <br />B, Miscellaneous Nees <br /> (1) Driveway w/curb @ $7,$0 <br /> <br /> (2) Dciveway w/o curio O~ $17.00 <br /> <br /> {3) Additional Pla:; Reviews or Addendnms <br /> <br /> (4) Investigation Fee <br /> <br /> (5) Reinspeetion Fee @ $25.00 <br /> <br /> (6) Other Inspections not listed above <br /> <br />...... x$40= __ <br /> <br /> <br />