Laserfiche WebLink
IiFOR CITY VALIDATION <br />ec~ived By: ~/]~.~ ~ <br />oning VaIidation:-"'//~ <br /> ate:- <br /> <br />COMPLETE ALL SECTIONS, 1 THROUGH 4 <br />1. JOB DESCRIPTION <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> COMMUNITY DEVELOPMENT CENTER <br /> 285 Church St, NE - Room 132: <br /> Salem, Oregon 97301 <br /> 8:00am-4:30pm Phone ~88-~147 <br /> 24 hr. Inspection L~ne 588-7904 <br /> FAX 588-7948 <br /> <br /> BUILDING PERMIT APPLICATION <br /> <br />FOR CITY USE ONLY <br /> <br />RESIDENTIAL COMMERCIAL Use of gtraetur¢: <br />( )Addition ( )Retheatlon ( )Addition ( )N~w zg~- ,/ MARI0N COUNTY <br /> <br /> ( )Almradon ( )Other (I )Al~tation ( )sig~~ ~LDING INSPECTION <br /> ( )Accesso~ ( )Chang~ofOecupancy (~ther <br /> <br />LOCATION OF INSTALLATION ':' <br /> <br />CONTRACTOR INFORMATION -- PLEASE INDICATE WHO IS DOING THE WORK <br />() <br /> <br />4. FEE SCHEDULE <br /> <br />A. <br /> <br />on squai~ footage ot project ) Valu*6on' $ ~.~ ~/o~-' <br /> <br />(I) P~rmit Fee <br /> <br />(2> 5% State Surcharge (.05 x Al) <br /> <br />(3) Structural Plan R~vicw (,65% x Al) <br /> <br />(4) Pim & L~t'~ Safety Plan Review (.40% × Al) <br /> <br />(5) Zonlag gu~:harg¢, if applicable (.05% x Al) <br /> <br />(6) Seismic Sumhm'gc <br /> <br />(2) Investigation Poe <br /> <br />(3) Reinspec0on Fee @ $25,00 <br /> <br />=$ <br /> <br />TOTAL <br /> <br />Permits are non-transferrable and expire if work is not stalled within 180 days of issuance or if work is suspended for 180 days, <br /> <br />Nall,¢ of Applicallt (Please ~int)' <br /> <br /> <br />