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FOR~CITY VALIDATI~)N MARION COUNTY BUILDING INSPECTION FO~-O--~ITY USE ONLY <br /> <br />Zoning ~alidatL°_._n: ~ Sal,m OI~gg0 97301 I ~ _ -- , - -- <br /> <br /> I / 3 <br /> <br />2 LOCATION.OF!NS~A~LATION : :; , : ~:: . ,~.~ j~~ <br /> <br /> Sub~v~ o~ ' ~ LOt ~ Bilk ~ <br /> LotWid* ~t~pth Ac~ f l~g'L°t X ~r Comm~i*Well ( ) Ci~ <br /> <br />3. CoNtRAcTOR 1NF0~A~joN ~ PLEASE ~ICATE5VH0 IS DOING THE wORK <br /> () <br /> <br />Registration NO. <br /> <br />4. FEE SCHED~E <br /> <br />A. 1. PE~T ~E: <br /> ' ~- ;~ s~i~g - ~ Ass~ <br /> <br /> 2' PLAN ~V~W FEE: <br /> <br />Permit Fee (A-I) <br />State Surcharge (5% of A-] ) <br />plan R~vi~w F~ (A-2) ~ '~'.a~.- <br />Invesfigafl~ Fee ($345 ~ sq ffi <br /> <br />Rc~ction Fee $25.00 <br />Oth~ inaction $40.~/per ~ (I ~ min.) <br />Ove~ime ins~ctlons $40;00/~ hr (2 ~mi~) <br />TOTAL <br /> <br />Dwelling labels must be obtained at Marion County Building Inspection and must be placed at the jobslte prior to inspection for plumbing, electrical and <br />mechanical work. Contact Marion County for Instructions. <br /> <br />I hereby certify that the above information i~ correct. Permits are non-Vmnsf~xable and expire if work is not started within 180 days of issuance or if work is suspended for <br />180 days. <br /> <br /> Date: <br /> <br />MC 15-80 Rev 1/~6 <br /> <br /> <br />