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FOR O~CE USE ONLY <br />Received by:, <br />Date: <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> <br /> 220 I-Ugh Street NE <br /> Salem, Oregou 97301 <br /> <br /> Ph~me 588-5147 $:00 ~u - 4:30pm <br /> C.a~-A-Fnom: 588-7904 i..~TE #: Permit No. <br /> <br />PERMITS ARE NON-TRANSFBRABLB AND NON-REFUNDABLE AND <br />EXPIRE IF WORK IS NOT STARTED W1TH]N 180 DAYS OF ISSUANCE <br />OR IF WORK IS SUSPI~IDED FOR 180 DAYS. <br /> <br />2A. CONTRACTOR IN~TAI, LATION ONLY <br /> <br />2B. FOR OWNER INSTALLATIONS <br /> <br />3. I~N RKv~w s~prrio~ <br /> <br /> We will p~vide plan ~view se~ice if you ¢ompleU~ Secti~a <br /> 5B and submit two (2) se~s of plans and specifications wilh <br /> this application. <br /> <br /> This optional plan review program does not suspend the <br /> required submission of lighting power calculations, plans, <br /> and specifications when requked by the Oregon Structural <br /> Specialty Code, Chapter 53. <br /> <br /> 15-34 11/91 . <br /> <br />~SPECTION N...,~ of Z.~,~O~,~r~.,,J:.,ea---i <br /> / <br /> S~ ln~ It.s ~t (e~) ~/ <br /> <br /> I~ ~s ~.~ 4 <br /> ~ ~5~.~ <br /> ~ $15.~ <br /> <br /> E~ ~d H~e ~ M~u~r <br /> <br /> ~1 ~ m ~ ~ _~.~ 2 <br /> ~l~m~ $I~.~ 2 <br /> <br /> R~ ~ ~.00 2 <br /> <br />5. FEES <br /> Al. Enter total of fees from Sec. #4 <br /> A2. Add 5% mrcharge (.05 x Al) <br /> <br /> B. Enter25% of lineAl for Hah Review <br /> (Sec. 3), if requlmi <br /> C. lnves~,,t{c~ ~or. 0i requi~i) <br /> D. Reinspection Fee (~25.00) <br /> <br /> TOTAL AMOUNT DUE <br /> <br />Receipt No. <br /> <br /> <br />