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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 588-5147 <br /> · '24 h~r./rn spl~s.4~o~ Line 3 T3~I4Z7 <br /> FAX 5887948 <br /> <br /> FOR CITY USE ONLY <br /> <br />City ~lnok Roquirone~m: <br />30/ f' <br /> <br /> · ,- ONE;& TWOFAMILY DWELLING PERMIT APPLICATION *lach~des electrie~ mec. h,mim¢ plumbing fees <br />COMPLETE ALL SECTIONS, 1 THROUGH 4 <br /> <br />1. JOB DESCRIPTION <br /> <br />~N~' Single F~anlly Dv~li~g With ~,~ched Ctarage <br />(') New6iagl~ ~ily Dwetllng With De~ch~t Gar~g~ <br /> <br />( ) New Duplex <br /> <br />] De~ched Garage Height: <br /> <br />NO. Bedrooms: q <br /> <br />4. FEE SCHEDULE <br /> <br /> A* VALUATION - Based on .. _.squa"e footage: <br /> Oro~s 8q Ft ~ x 64.66 <br /> Garage Sq ft ~ x 16,27 <br /> TOTALS: ~O~ <br /> 1, pERMIT FEE: <br /> Gross Sq Ft' c~D~O x $345/sq it <br /> ' Building <br /> <br /> GrossSq~t a.~ x $.l~sqet <br /> <br />B. PERMIT FEES <br />3. ~a. ~i~ F~ (6-2) ~ ~ = $ ~ ~ <br /> <br />I~inspection Fee $25.00 <br /> <br />Other inspection $40.00/imr ht (l ~ mm.) <br />Ov~ime inspections $40,0~,~er hr (2 hr min.) <br />TOTA~.~ ~1~ ~"~/m~ ~/ <br /> <br />Dwelling labels must be obtained at Marion County Building Inspection and must be placed at the jobsite prior to inspection for plumblm~, electrical and <br />mechanical work. Contact Marion County for instructions. <br /> <br />I hereby certif~ that lh¢ above information is ~orrect. Permits arc non-transferrable and expire if work is not star~ed within 180 days of issuance or if wonk is suspended for <br /> <br />180 day~. <br /> <br />Signa~re of Applicant: <br /> <br />MC 15-~0 Rev 1~6 <br /> <br /> <br />