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Received By: ~ <br />Zoning Validation: <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> <br /> 220 !4igh Street NE <br /> Salem, OR 97301 <br /> g:00ara - a~30t~ Pllonc 5g~-St47 <br /> Code.A.Phon~ 588-79C4 <br /> FAX 588-7948 <br /> BUILDING PERMIT APPLICATION <br /> <br />COIvI~LETE ALL SECTIONS. 1 Tt'~OUGFI 4 <br />1. Job Description <br /> <br />2. Location oflj~stallafion,, ,, . /]~5,~_ L,~ ¥7~o,~ <br />~o~Aa~ if~ /~0, lSO. /qO. 150. lbo 170 <br /> ,. I , ,, <br />Mo~c H~ <br /> L~h ~ Acres <br /> <br />3. Contractor.~formafion ... <br /> <br /> ) I own, reside in, or will reside in tho completeA structure, <br /> <br /> ) I understand that I must mgismr as a Construction contractor ff the Strue~uro is sold or offered for dale bofom or UlX, n oeeaplet~on, <br /> <br /> ) I will be my own gmoml contractor, <br /> <br />If I him subcontractors, I will hire only subcontractors registered with the Construction Ctmtraetor~ Board. ff I change my mind and do hire a general contractor, I win contract <br />with a contractor who i~ re&qst~md wltl~ Col~stmqtlorl Cmtractor's Board,Ao/~/~l i~anediately notify Marion County of the name of the comracton J:r ~ "S' <br /> ". ' .,_,.,-,~'~";';'.,2 ' ~ - ." t--~,'~ ., , ?~' ~,t / <br /> <br /> d I am a registered builder OR the authofivx3d repre~enta6w of a mglste, md btfildor,,. ...... , .... ~,. <br /> <br />4. Fee Schedule , <br /> <br />A. VALUATION' (See "Valuation Schedule" <br /> <br /> square footage,) <br /> <br /> (1) Permit <br /> (2) 3% Stat~ Surchat'ge (.05 x Al) <br /> <br /> (3) Stmetul'al Plan Review (,65% x Al) <br /> (4) ["ire & Life $ffety Plan Review (,40% <br /> <br />_,g& qS'- ' <br /> <br />O) Site Plan Rev/ew (eornmercial only) @ $79,00 <br />(4) Addltlonal Plan Re'Aews or Addendums = <br />($) Inves6gafion <br />(6) Re~a~ion F~ @ $2~.00 <br />(7) Other Bast~cfions no~ li~ted above <br /> <br /> <br />