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Ip.l~OR CITY VALIDATION MARION COUNTY BUILDING INSPECTION I FOR CITY USE ONLY <br /> +ived By: .~.~ COMMUNITY DEVELOPMENT CENTER I <br /> 285 Chumh St. NE - Room 132 Icity ~tba~k Roquirm~nts: <br />[Zonia~g Validation: ~ Salem Oregon 97301~ <br /> · : ': ' ' *lnchtdes electrical, mechanical, p~ <br /> <br /> ;':(~NewSingie'g~ilyDwalli~gW~:A~c~dG~g* ~ ': ~ ' d~/~} · <br /> <br />() <br /> <br />1 ~nl an ~UTHORIZED REPR~S~NTATIV~ of the proper~y owner or contractor. <br /> <br /> (pl~.s* print) <br /> Mailing Address <br /> <br />4. FEE SCHEDULE <br /> <br />VALUATION - Based on square footage: <br /> ~rag~ Sq fl ~ x 16.27 <br />1 ~E~ FEE: <br /> <br /> TOTAL 5.345 PER SQ FT <br /> <br />s~ <br /> <br />5. Investigation F~ ($345 p~r sq f0 <br /> Reinspection Fe~ $25.00 <br /> <br />7, Oth*r inspg¢fion $40,00/p~r hr (1 hr rain.) <br /> <br />8. Overtime insp~etibns $40~0Wpe~ hr (2 hr m n ) <br /> TOTAL <br /> <br />B. PERMIT FEES <br /> <br />2. <br /> <br />Dwelling labels must be obtained at Marion County Building Inspection and must be placed at the jobslta prior to inspection for plumbing, electrical and <br />mechanical work. Contact Marion County fo~' instructions. <br /> <br />I hereby ce, ct/fy that the above information is correct. Permits are non-transferrable and expire if work is not started within 180 days of issuance or if work is ~usgended for <br />180 days. , <br />NameofApplicant(Ple~,~rint): .~ ~,~it~}tt ~. ~ ~y Phone: <br />Signature of Applicant: ~Z~ ' ~Z~ ~b~x ~, Date: <br />MC 15-80 Rev 1/96 ~--J <br /> <br /> <br />