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~ ~ MARION COUNTY BUILDING INSPECTION ........................................................... <br />i ~.O]~ CITY USE~O~,Y , f.~ ~.~t I COMMUNITY DEVELOPMENT CENTER FOR CITY USE ONLY <br />Received By: .'~ .~1~. Date: ~L_~_ I 3150 Lancaster Dr. NE - Su~ C Citv Setb""ks' <br />I Zonln~ B~y: ~ Ci~l Salon~ Orcgonl97305 F~x~tY'.' <br />..................................... :4 hr. ~p~o. L~,~I Gyiy/' <br /> <br /> TwO <br /> Ine~des e~eal, ~eha~l, p~ <br /> <br /> () N~si~eFa~ly~ll~g~De~eh~Ga~ge () N~pI~G~ <br /> <br /> ~u~: f~ ~ Ener~: <br /> Sq~.r~F~: ~t: O ~V~:7~2~aV~: ~$~ ~: <br /> <br /> N~ofB~: ~ E~: ~: ~ ~eR~gHei~t: G~geHei~t: <br /> <br />2. LOCATION OF INSTALLATION <br />P~I ~: Maili~ ~' Z$ 6 7 ~t~ ~ Zip: <br /> <br />Property Locate: Parcel g: <br /> <br />City Sewer ~ <br />Septic System __ <br /> <br />WatetSul~ly: ( ) PrivataWell ( ) C,o~mmnityWell ,k~City <br /> <br />3. CONTRACTOR INFORMATION -- PLEASE INDICATE WHO IS DOI~G THE WORK <br /> <br /> () 1 amthe PROPERTY OWNEROnd o,~a% reside in, or will reside in the completed stmctarcand will be my o,a,n gonea-~lcoffwa~t~. I und~gamd that 1 must regil~ <br /> as a construction contractor if the stmetare is sold or offered for sale before or upon completion. [fi hire subcontrac~rs, [ will hire only sul~atraetors registered with <br /> the Consiametion Coffaaetors Board. Ill change my mind and do hke a general contractor who is registered with the Construction Contractors Board, I will <br /> immediately notify Marion County of the name of the cco~etor. <br /> <br /> ( ) I am the AUTHORIZED REPRESENTATIVE of the property owner or the contractor. <br /> Business Name (please print) <br /> <br /> Mailing Address: <br /> Street City Zip Phone <br /> <br />I am a CONTRACTOR regis~red with the State of Orego/L <br />BusinessName(pleaseprint): ~ HOS%~,~"~ ~'t('~el~D~t_.ttw~-: <br /> <br /> Steer City Zip <br /> <br />4. FEES <br /> <br />VALUATION (See Valuation Schedule to detexmine I~ v~duation based on square <br />lbotage) <br /> LivmgAma SquareFeet/~O-~ x $64.66 = $ ?0717-9~ <br /> Oarage Square Feet ~-t~'[ x $16.27 = $ '~"~"5-/. <br /> <br />Fax <br /> <br />B, Fee Summary <br />(1) Permit Fee (A-1) $ '750- $ 7 <br />(2) State Surcharge (.05% x A-1 ) $ ~"7. <br />(3) Plan Review Fe~ (A-2) $ <br />(4) Additional Plan R~view/Addeadum ~ $50/hr, <br />minimum ~-balf honr. $ <br />(4) Zoning Surcharge, if applicable ($30.00) $ <br /> <br />Gro,,Sq.ar, Fee, /~;~ x s0.40so = s 75'0'g7 <br /> <br />Building @ $0.185 per sqonre foot <br />Electrical ~ $0.090 per square foot <br />Mechanical ~ $0.040 per square foot <br />Plumbing ~ $0.090 per square foot <br /> <br />(5) Investigation Fee ($.4050 per sq. fl.) $ <br />(6) Reinspeetion Fee, $50.00 $ <br />(7) Inspections made outside of normal <br />hosin~,s hours, $50/hr, minimum two hours $ <br />(8) Inspections for which no fee is specifically <br />indicated, $50.00/hr, minimum one hour $ <br />(10) Fonndafion Only Authorization, $25.00 $ <br /> <br /> <br />