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] FeRoCITY VALIDATIONI MARION COUNTY BUILDING INSPECTION <br />II~ec*iv~d-B~: ~ I cometary DEVELOPMENT CENTER <br /> 285 Church St. NE - R~m 132 <br />[Zoning Vali~tio~/ ~ I S~em, ~e~n 97301 <br /> 24 hr. Imp~on Line 373~427 <br /> <br /> FOR CITY USE ONLY <br /> <br />~on~ ~D ' ~ ~ / <br /> <br /> ONE & TWO FAMILY DWELLING PERMIT <br /> *Includes electrical, mechanical, plumbing fe~J~ ~ ~ ~/ ~'~ ~ , ' <br />COMPLETE ALL SECTIONS, 1 THROUGH 4 <br /> <br />1. JOB DESCRI~PTION aa <br /> ( ~ew Single Family Dwelling With At~aehed Cmxage - - · <br /> <br />( ) New Single Family Dwelllng With Detached Garage <br />( ) New Duplex <br /> <br />2. LOCATION OF INSTALLATION <br /> <br />MARION COUNTY <br />BUILDING INSPECTION <br /> <br />( ) i am a CONTRACTOR registered with the Sta~ of Oregon. <br /> BU$in~/Name ~leae~ taint) Registration No. <br /> <br />4. FEE SCHEDULE <br /> <br />Phone <br /> <br />Ao <br /> <br />VALUATION - Based on square footage: <br /> <br /> TOTALS: 17~'2-. = $~o. <br /> 1. PERMIT FEE: <br /> Gross Sq Ft [~O~ x $.345/sq fl $ <br /> * Building ~ .185 p~sq R <br /> Electrical ~ .068 per sq ft <br /> Mechanical ~ .022 p~r sq fl <br /> Plumbing ~ .070 per sq ft <br /> TOTAL $.345 PER SQ FT <br /> <br /> Z. PLAN REVIEW FEZ: <br /> ClrOSsSqFt /~11:~9 x $.12/sqR S <br /> <br />B. PERMIT FEES <br />1. Permit Fee (A- 1) =$ <br />2. Siam Surcharge (5% of A-1 ) = $ ~,~ ~ <br /> <br />3. Plan R~view Fee (A-2) ./~ fff~r.~ ~, / = $ ~ <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 informatio~.~orcect. Permits a~ non-transferrable and expire if work is not started within 180 days of issuance or if work is suspended for <br />180days. f t } . J <br />NameofApplicant (Pleas~~ ~ ~[4=.~ ~-'Nt~ Phone: (~3~,) -~0~-- <br /> <br />MC 15-80 Rev 1/96 \ I <br /> <br /> <br />