Laserfiche WebLink
F°R 0FF'ICg USE ONLY1 <br />Zoning Validaiio~ ~,~- <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> <br /> 220 High Street NE <br /> /¢//C'2. t· Salem, OR 97301 <br /> 'i t t~:00 ara-4t30pm Phor~ 588-5147 <br /> a ~' · Code-A-Phone 588-7904 <br /> ~//' ~ FAX 588-7948 <br /> <br /> MANUFACTURED STRUCTURE PLACEMENT <br /> PERMIT APPLICATION <br />COMPLETI~ ALL SECTIONS, 1 TI.IROUGH 4 <br /> lob Descril~iou <br /> <br />ILeftsi~mshtsla¢'/~" I <br /> <br />........ Rosiaen:ial( ~ New( ~' Replaeern~t( ) Gauge ~ Camo~ <br /> ( ) <br /> C~m~al( ) New( ) ~placemmt( ) ( ) D*tach~d <br /> <br /> M~uhaumfs Year of Color of L~g~: ~ Widt <br /> <br />Location o£ Installation <br /> <br />3. Contractor Information <br /> <br />( ) I onderstand Ihat I must register as a construction contractor if the st.nleture is sold or offered for sale before or <br /> <br />ff I him ~ubeontractors, I wi]I Im only subcontracto~ registered wlth hhe Construction Contractors Board, <br />If I change my mkl~ md do hil~ a general Contrmor, I ,~11 riontract with a aoBtl~¢tor who is registered with the <br />immed~tely ~totlf~ Ma6on County o f tba name of t~ contractor. <br /> <br />( ~ am a ~gistem¢ bO~d~r OR Ce au¢od~ m~n~fivo of a mgJs~d b~leer. <br /> <br />4. Fee Schedule <br /> <br />A. (1) Manu£actuted Home <br /> or Modular Unit Pla@em@hr/Connection <br /> <br /> (2) State Fee <br /> <br /> ¢3) State <br /> <br />B, (1) ~g.'d Stm¢~am <br /> (2) Mfg/d 5~cm~ Storage R~awal <br /> <br /> O) ~S Su~o (15.~ if app~ble) <br /> <br />C. Addifionallnspextlon @ $60,00=__ <br /> or Reinsl~c'don <br /> <br />service or plumbing water/sewer I~es are set.state required permil~, MC 15 64 Rev 11-91 <br /> <br /> <br />