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MARION COUNTY <br /> <br />DEPT. OF BUILDING INSPECTION <br /> <br /> ~ ~ ~lem, Oregon 97301 <br /> Ph: S~:S147 Plbg. Permit NO. 534 <br />By: <br /> <br /> 7/~ 7/84 <br /> <br />Address: .572 N l~r'H ST AUMSVlLL][~ Sec. Twnshp. Rge. <br />Owner; AUMSVILL~: ELM SCHOOL Phone: Address; <br /> <br />Plbg. Installer HOIVLE]~, HUt,13L]~A[J(;H INC Address ~ SOX 366 STAYTON 9738:~hone 769-643/* <br /> <br />TYPE,OF PERMIT ' ,~ NO. O~¢ iTEMS FEE ON EACH TOTAL AMOUNT <br />Base Price ' , , $10.00 <br />dential <br />Resl . . <br /> New Construction (each fixture) · , , $ 7.50 <br />Alterations (each fixture) .... 7.50 ..... <br />Water Lines <br />20.00 ' ' <br />For the Erst 100 teei or fraction thereof <br />Sewer Service Lines ..... <br />First 100 feet or fraction thereof ...... ,30.00 <br />Addltl~)nal 100 feet ., ...... 15.00 <br />Commercial , ,, <br /> ' New construction (each fixture) ,, ,, 7.50 ' <br /> Alterations (each fixture} ' ' /+ 7.50 30.00 <br />Lawn Sprinkling System , <br />TO and including each protective device , .. 5,00 <br /> <br /> · FEE , ~0 <br /> Pleas return comple a c on , <br /> with the'indicatedfee. ' ' ......... URCHARG.E (4%). . . 1 <br /> : TOTAL <br /> <br />I agree to perform work according to the submitted plans and specifications, the laws of the State of Oregon and the <br />Ordinances of Marion County.. Permit expires if work not commenced within 180 days. I further expressly warrant that I <br />comply with the provisions of ORS 701.005 to,701.125 because: <br /> <br />( ) <br /> <br /> ) <br />( <br /> <br />I am a registered and licensed plumber or <br />The authorized representative of a registered and licensed plumbing 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 />iNATURE OF <br /> <br /> <br />