Laserfiche WebLink
FOR CITY VALIDATION <br />Received By: __ = <br /> <br />Zoning Validation: <br /> <br />Date: <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 588-$147 <br /> 24 hr. Inspection Line 588-790d <br /> FAX 588-7948 <br /> <br /> BUILDING PERMIT APPLICATION <br /> <br />COMPLETE ALL SECTIONS, 1 THROUGH 4 <br />1. JOB DESCRIPTION <br /> <br />FOR CITY USE ONLY <br /> <br /> RESIDENTIAL COMMERCIAL Use of Stttlcture: 4 ~ ~ <br /> ~Addition ( )Rel~a~on ( )Addition ( )New <br /> ( ) A[tera~on ( ) O~er ( ) Alte~tion ( ) Sign <br /> <br /> ( )Accesso~ ( )Ch~geofOecup~cy ( )O~er ~tl~ <br />~fipfionofWork , I ~isahis~fic~buil~ng? Yes - ~ <br /> <br />2. LOCATION OF INSTALLATION <br /> <br />3. CONTRACTOR INFORMATION -- PLEASE INDICATE WHO IS DOING THE WORK <br /> <br /> 1 am the PROPERTY OWNER and own, reside in, or will reside in the completed stmalun: and will be my own general contractor. I understand that I must register as a conm~ction <br /> <br />4. FEE SCHEDULE <br /> <br />A. <br /> <br />(1) Permit Fee <br /> <br />(2) 5% State Surcharge (.05 x Al) <br /> <br />(3) Structural Plan Review (.65% x Al) <br /> <br />(1) Additional Plan Reviews or Addeudums <br /> <br />(2) Investigation Fee <br /> <br />(3) Reinspection Fee @ $25.00 <br /> <br />TOTAL = $ <br /> <br />=$ <br /> <br />I hereby certify that the above information is correct. <br />Permits are non-transferrable and expire if work is not started within 180 days of issuance or if work is suspended for 180 days. <br />Name of Applicant (Please Print.): ~t"l Z- ~'~ Phone: <br /> <br />MC 15-73 Rev 1/95 <br /> <br /> <br />