Laserfiche WebLink
FOR CITY USE ONLY <br />R~eived By: J)ate: <br />Zoning By: City: <br />Receipt #: Amount: $. <br /> <br />MECHANICAL PERMIT APPLICATION <br />Please complete all Sections, I through 5 <br /> <br />I. LOCATION OF INSTALLATION <br />parcel ID: <br /> <br />City: ~V)llt~. Zip: <br /> <br /> 7'/'/ <br />Cross Street~Directions: <br /> <br />Pwject Description: <br /> <br />PERMITS ARE NON. TRANSFERABLE AND EXPIRE IF WORK I <br /> IS NOT STAR~ED WITHIN 180 DAYS OF ISSUANCE OR IF <br /> WORK IS SUSPENDED FOR 180 DAYS. <br /> <br />2A. CON'fRAC~POR INFORMa%TION -- PLEASE INDICA~PE <br />WHO IS DOING THE WORK <br /> <br /> ConUactor: <br /> u ngAd ,s: //! <br /> City: ~ F/LI~'4"~ Sine: (2~ ZiP:e~7~/ <br /> <br />Contrac~rs Board <br />.gis atio. <br /> <br />Property Owner: (please prinO <br />Mailing Address: <br />City: State: Zip: <br /> <br />I am the PROPERTY OWNER and own, reside in, or will reside in <br />the cavnpleted structure and will be my own general contractor. 1 <br />understand that I must register as a construction contractor if the <br />structure is sold or offered for sale before or upon completio.~ lf l <br />hire subcontractors, I will hire only subcontractors registered with <br />the Construction Contractors Boara~ If l change my mind and do <br />hire a general contractor who is registered with the Construction <br />Contractors Board, I will irnmedi~tely notify Marion County of the <br />name of the contractor <br /> <br />Owner's Signature: <br />Agent's Signatun:: <br /> <br />3. PLAN REVIEW SECTION <br /> Mm~ion County does not require a plan review. We will provide plan <br /> review service if you complete Section 5B and submit two (2) sets of <br /> plans and spec fications with th s application. <br /> <br />MC 1541 Rev 9/98 <br /> <br />MARION COUNTY BUILDING INSPECTION <br />COMMUNITY DEVELOPMENT CENTER <br />3150 Lancaster Dr. NE - Suite C, Salem, Oregon 97305 <br />8:00am - 4:30pm <br />24 HR Inspection Line 373-4427 FAX 588-7948 <br /> <br />4. FEE SCHEDULE (complete and emer total in Al) <br /> <br />(~ R~SIDENTIAL ( ) COMMERCIAL <br />( ) NgW 0/~) ADDITION <br />( ) RELOCA1/ON () P,~PLACEMENT <br /> <br /> ( )~s (~crPaC <br /> <br />One/TwoFamgyOwell~gF~:SquareFeet: -- x $ .04=$__ <br /> <br />5. FEES <br /> <br /> Al. Enter total of fees from Sec. <br /> A2. Add State Surcharge ~3qSv x Al + Base Fee) $ ~_ <br /> <br /> B. Falter 30% of line Al for Plan R~vinw $ <br /> C. investigation Fee (if rexluimd) $ -- <br /> D. Reinspection Fee ($50.00) $ <br /> E. Additional Plan Review ($62.50/hr, <br /> minimum one-half hour) $ -- <br /> F Inspection for which no ~ve s spec fically n6ica~d,~4~i <br /> ($62.50/hr, minimum one hour) $ -- <br /> G. Inspection Outside Normal Business Hears, <br /> ($62.50/hr, minimum two hours) $ -- <br /> H. Seismic Fee (.01% x Al)) $ <br /> <br /> <br />