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Plumbing Permit Application <br /> <br />Appl. Recd: [.~)~l~/~ <br /> <br /> ats,, /- <br /> <br /> MARION COUNTY Plumbin§ Permit Application <br /> DEPT. OF BU!LDING INSPECTION <br /> Senatdr Building ~ 225 <br /> 220 High St., N.H. 2nd Floor BIdg. Permit ,o. '~2 '"~<~) ~(~') <br /> Salem, Oregon.97301 <br /> R.H. <br /> WITHROW, BLDG. ADMINISTRATOR Plbg. Permit NO.~ <br /> ' 588-§147 --' 588-5148 <br />5:00 P.M.- ............ CODE-A. Phone 588-5373 ............. 8:00 A.M. Date; I --~ --~/ <br /> <br />Bldr. & No.: Phone: ' , Address: , <br /> <br />Plbg. Installer ~% ..... / ~'~ Address Phone · <br /> <br /> TYPE OF PERMIT NO. OF ITEMS FEE ON EACH TOTAL AMOUNT <br />Base Price $10.00 <br />Residential ' · <br />KitChen Unit. Includes Wat~ Heater "" ' ~ / $15,00 <br /> Bath Unit (full) ,. ,, , / 10 00 <br /> Bath Unit (half) ,- 5.00 <br /> Laundry Unit · . / 5.00 <br />Miscellaneous Fixtures . ' 5,00 <br />Sewer Service Line ' <br />· Private - Shall be c~arged per 100' or fraction thereof · , ' 10;00 <br />Cdmmercial ' .. ,, · ~ <br />I to 50 Fixturee 5.00 ea. <br />Over 50 Fixtures ' <br />· · 3.00 ea. <br />Alterations & Additions '. _ ...... , <br />Charged et Commercial Bates <br />System <br />n Sprinkling " <br />, ,FEE <br />y ' ' ORe / <br />Please return complete application · ' S HARGE' <br />with the indicated fee. . , <br />~)//-- <br />TOTAL <br /> <br />I agree to perform work according to .the submitted plans and specifications, the laws of the State of Oregon and <br />the Ordinances of Marion County.' Permit expires if.work not commenced,within 120 days~ I further expressly war- <br />rant that I comply with the provisions of'ORS 701.005 to 701.125 because: <br /> <br />I am a registered and licensed plumber or <br />The authorized representative of a registered and icensed plum._bing contractor. <br /> <br />The work will be performed by a registered and licensed plumber <br />I am performing work on a property I own or occupy <br />Other (please specify) <br /> <br />SIGNATURE OF APPLICANT/~ <br /> <br /> <br />