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Application Received
<br />
<br />Date ~
<br />
<br /> Mar ~n :county
<br />,:DEPT. 0E BU!LDING INspECTION
<br />
<br /> SALEM'0RE(~ON97301 : :
<br /> FOR
<br />
<br />hiring outside help r'-]. :Indicate status,
<br />
<br /> PLUMBING '
<br /> UQENSE NO. ,
<br />
<br />IHOM: BUILDE R~;
<br /> REGISTRATION NQ
<br />
<br />Owner
<br />Plbg. installer ~----~ Z.~'~'.,~¢.-. ' Z ,' Aa~r
<br />
<br />Residential . ,
<br />
<br /> Kitchen Unit Includes Water Heater · ' ~ ~ - $4,00
<br /> I~ath Unit (full) · ~ $5.00 /~ ~'-
<br /> Bath Unit (half) . · / $3,00
<br /> Laundry Unit ~ '" "' .......
<br /> · · . l .T, ,......-:.. ....
<br /> M~scellaneous Fixtures-, ', . , . · , ' ,' $2,00
<br />Sewer Service Line , , : : · ,.,' ' , '. : $3,00 ,
<br />With Plumbing Turn-around : ' · '" "'~ ;'" $5.00 ,'
<br />Commercial ' · · "". · · "' ", ' '. ' " ·
<br />, .1 to 50 Fixtures ' ,, ' , ..... "', ', , " , $2.00ea. Z
<br />Over 50 Fixtures ' · '' .': · $1.00 ea.
<br />Alterations & Additions . · ' "' ' · ' , , ,: · ·
<br /> Charged at Commercial Rates ~., ' · ' ': · " ':' . I
<br />Lawn Spr~nlchng System ' ? '_ :~: ,: ,, , ,:" · · '.", .. · .....
<br />To and, including each protective, device ,," '~' . :', .. : $2.00
<br />' ,. · ',..J:'"', '..'"" :TOTALAMOUNTALI~ITi~MS.
<br />
<br /> : ..., ,:, ;':: :?" ', 'i,:' ' ,~ : ~.' .......... SURCHARGE , ' . . , f'
<br /> ....... GRAND TOTAL Z~'~ ~'~'
<br />
<br />I certify that all plumbing work will be done in accordance with applicable provisions of Oregon Revised Statutes Chapters 447
<br />and Sg3 and applicable codes, and that no help will be employed unless icensed under ORS 69:3.
<br />
<br /> Complete Application With the Indicated Fee.
<br />
<br />
<br />
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