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I~OR CITY VA.LIDATION MARION COUNTY BUILDING INSPECTION <br /> fg,~ . . .-, I ' ,~n COMMUNITY DEVELOPMENT CENTER <br />Receive, day: ~ttf C~ ~ ~ 285 Chureh St. NE - Room132 <br />........ W~ I Salem, Oregon97301 <br />~omng vm~dat~on: ' ~ [ 8:00am-4:30pm Phone 588-5147 <br /> <br />FOR CITY USE ONLY <br /> <br /> TWO FA~LY D~LL~G PE~T APPLICA~ ..... ~ ~ <br /> <br />CO~LE~ ALL SECTIONS, 1 THROUGH 4 <br />1. JOBDESC~TION ~- O~Oq 0CT - 8 ]9~6~ <br /> ( ~ew Single F~ily Dwelling Wi~ A~ehed O~ [~}0 [~ ~0~ {~ <br /> ( )NewSingieF~ily~ellingWithDemch~G~age B~iLDIN~ INSPEGTI0~ <br /> ( ) New Duplex <br /> <br />2. LOCATION OF INSTALLATION <br /> <br />Other:. <br /> <br /> ~cfion ~ ( To--hip ~ ~ge ~ ~ ~ne ~ y Map ~ Wa~S~Iy: <br /> <br />3. CO~CTOR ~FO~TION -- PLEASE INDICATE ~O IS DOING T~ WO~ <br /> <br />Mailing Addazas <br /> <br /> Phon~ <br /> <br />4. FEE SCHEDULE <br /> <br />VALUATION - Based on squa~ footage: <br /> <br /> om~Sqa 7" ~ x 16.27 <br /> <br /> ~SqFt ~/O ~ x$.345/sqR <br /> <br />B, PERMIT FEES <br />1. Permit Fee (A-I) =$ <br />2. State Surcharge (5% orA- I ) =$ 70, <br />3. Plan Review Fee (A-2) <br /> <br />5. Investigation Fee ($.345 per sq fi) = <br />6. Reinspection Fee $25,00 = $ <br />7. Other inspection $40.00/per hr (1 hr min.) = $ <br />8. Ove~ime inspeetinns $40.00/per hr (2 hr min.) ~ $ <br /> <br />Dwelling labels must be obtained at Marion County Building Inspection and must be placed at the jobsite prior to inspection for plumbing, electrical and <br />mechanical work. Contact Marion County for instructions. <br /> <br />I hereby certify that the above information is correct. Permits are non-transferrable and expire if work is no~ started within 180 days of issuance or if work is suspended for <br />180 days. <br /> <br />Signature of Applicant: Ng2~'d - ,/~..,,~'g~.~ Date: <br />MC 15-g0 R~vlD6 <br /> <br /> <br />