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MARIOI
<br />
<br />PLUMBING PERMIT
<br />
<br />Owner: /3 ~ . ,,'t,, , Phone:
<br />~um~ngJns~ let: ~ ~ · · Phone
<br />": '.' .,
<br />Home Builderb RegistKatlon/N0.:,/ ~ ~"~, ' ' , , '.,~., %,, '<~ .'. · ,,
<br />'Residential: ~ '" ~ New: .~ ~ Addition;
<br />
<br /> ' ' ' ' ,AMOUNT:'
<br /> . ~,FEE, ,.
<br /> ' "~ ~ ~ ...... · :$2000 :,
<br /> Base Price , . ·., ..... .,
<br /> Resident e
<br /> New construction (each fixture)
<br /> , Alte~atl~ns'(each fixture) ' ' . . ~ ~ ~ ~ ~ ~,:,~,, ,' '~, :; ', ":"' ', ' ': ' '
<br /> ,? ~, 9.00 ,
<br /> N~ (
<br /> Alterafl~n~(eec~fixture)... .. '~ ~, ~>.~ ,J · ~. ~ ,. .... ,9.~, · ' "
<br /> WaterLines '". .... . .
<br /> ForthefirstlOOfeetorfra~ion,there~ ' BUILDING :IN:St EOTION,:
<br /> Lihe~
<br /> First 100 feet or fract on hereof 3~.00 3~. ~'
<br /> AddltionallOOfeet ' "", ' ' ..,,~ ..... · , ., , <, 1~,00 , '
<br /> Other (~s per OSPSC and Bu Iding Off ¢ ~)
<br /> On:Site Technical Review (apply at Marion Coun~ ~nly ,
<br /> $
<br /> STATE SURCHARGE
<br />
<br />P ease return COMPLETE APPL CAT ON ..... E~EE~gU~ N~BG~ ~ ~ ~ ....
<br />w~th the ~nd~cated fee. , ,
<br />
<br />( ).,,A~m per forming work on a proper ty I Own or occupy. ·
<br /> ~ ~1 am a registered builder OR the author ~ed representative of
<br />
<br /> ~'~) The work will be performed by a registered builde~
<br />
<br />M0,15-45
<br /> 12/87
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