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VoR OvFI oSLy <br />[ Zoning Validation: ~--~.. <br /> <br /> COMPLETE ALL SECTIONS, 1 T~ROUGH 4 <br /> I. Job ])escrip~on <br /> <br /> MARION COUNTY BUILDING INSPECTION <br /> 220 Hig]~ Street NE <br /> Sale, m, OR 97301 <br /> 8:00am-4:30pm Phone 588-5147 <br /> Code-A-Phone 588-7904 <br /> FAX 588-7948 <br /> <br />ONE & TWO FAMILY DWELLING PERMIT APPLICATION <br /> <br />( JNew Single Fmnily Dwelling w/garag~ <br />( ) New Single Family Dwelling w/o garage <br /> <br />( ) Garage, attached <br />( ) ,Garage, detached <br /> <br /> ? <br />Tress (~ or Rafter ( ) I No., Sloric~s / , j Detached Garage Height: <br /> <br /> FOR OFFICE USE ONLY <br /> City Setba¢,k Requirement.q: <br /> <br />MARION COUNTY <br />BUILDING INSPECTION <br /> <br />2. Location of Installation <br /> <br />Mobile HO~e Pick <br /> <br /> Site No, <br /> <br />'~ne ~ Map Water Su~ly: <br /> Co,m~t Privato Well ( ) Spring <br />I~*g, ~t ~ ~ Community Well ( ) City <br /> <br /> Contractor Information <br /> <br />~I own, r~ide in, ~ will m~ide in th* completed ) I understand that I m~t re~ster as a construction eon~a~ if ~ s~ is sold or offered for sM¢ ~for~ or u~n completion, <br /> <br /> ) I will ~ my own general <br /> <br />who is registered with the Construction Contractor's Board, Z will ~l.~th~y notify Marion County of the name of the contracor: <br /> <br /> ( ~ I am a regj*tored builder OR ~ authofi~d re~esentafive of a registered b~ld~. <br /> <br />4. Fee Schedule <br /> <br />A. New On*-al~d-Two Family ]>welling Cod~ <br /> (inlcudes El, Me, <br /> <br />(2) 5% State Surcharge (.05 x Al) <br /> <br />(g) Plan Review <br /> <br />(4) 7~ng Surcharge ($15 if appllcable) <br /> <br /> B. Miscellaneous Fees <br /> <br /> (1) Driveway w/curb @ $7.50 <br /> <br /> (2) Driveway w/o curb @ $17.00 <br />= ~, ~9 (3) AdditionalPlanReviewsorAddendums <br />= ~,,.9: 3-02/ (4) Investigatiou Fee <br />-- $185.00 (5) Reinspection Fee @ $25.00 <br />= --?~'~ (6) Other Inspections noLlisted above <br /> <br />x$40= -- <br /> <br /> <br />