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Application Received
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<br />°ate '7--/"G' *'":7
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<br />Appllcatlon Approved
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<br /> Marm~
<br /> .,.,ouu~y.. '. : .
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<br />DEPT. OF BUll. DING INSP,E~T ON ·
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<br /> ,:~ ,, . SA[~M 'OREGQN.~7$~I,'r '. '
<br /> 588-5147
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<br />APPLICATION FOR,PLUMBING PERMIT
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<br />Plbg' Permit.#
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<br />NOTE:
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<br />Job Address
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<br />Applicants muSt hold Oregon Registration- to conduct a p umb ng business [] or must be property ··owner/operator not
<br />hiring outside help E~. Indicate status.
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<br /> PLUMBING '
<br /> BUSINESS HOME BUILDERS
<br /> L CENSE NO. 24--22 ..... ~{EGIST,RATION NO.
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<br />Owner~ ~2~--~z~', Address ' Phone
<br />Plbg, Installer Juc].~o= ~ 'r ' '' · Address.,.~.eO"]~OX 22~8:~' ,Salem ~)?~50.8 Phone
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<br /> · ' TYPE OF PERMIT , . ' ' · NO. OF ITEMS FEE ON EACH TOTAL AMOUNT
<br />- Base Pr ce ' ' '" ' ' ' ' $ 5.00
<br /> Residential .... · /. , . , '" . ,
<br /> Kitchen Un .... t nc udes Water Heater'" · ' . , ': . ' i $4.00 ' g/, ~
<br /> B.ath Unit (full) , , ~ $5.00 /~. ~
<br /> Bath I.~.n.[t (half) '" ,.. ' ' : ,(,,'" _,;, , $3.00 ~, 0 ~
<br /> Laundry Unit .., . . · ' ~ "$'3.00
<br /> M!~ellaneous Fixtures ....... . ' - ' - .. $2.00
<br /> Sewer Service..Line ' "~.!.'. ' ' ' · '.' ' $3:00
<br /> With Plumbing Turn-around ' ' ' '
<br /> ., ., $5.oo,
<br /> Commercial. , ' ...... , . · ..
<br /> 1 to 50 Fixtures " .... $2.00 ea,
<br /> Over 50 Fixtures : ' ·, <', ~' ' ' ., ' 00 a
<br /> AIterations&Addtons. .. :., .'. ~ ~, , .'; ,' ; , · , , :
<br /> Char~ed.,at Commercial Rates
<br /> Lawn Sprinkling SyStem ' '"
<br /> To and inc ud dg each protect ye device ... ·, ' · '
<br /> . ......... ' $2,00
<br /> · :': , TOTAL AMOUN~ ALL ITEMS ~
<br /> ~:~ ·. SURCHARGE ~_j"
<br /> , ' ' ' D TOTAL '<~A~ .
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<br />I certify that all plumbing work w be, done in accordance with applicable provisions'of Oregon Revsed Statutes Chapters 447
<br />and 693~,and~applicable codes, and that no :help will be employed, unless licensed under ~RS 693. ,
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