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Apphcation Received <br /> <br />Date ___, <br /> <br /> Application AppFe~ed <br /> <br />By h <br /> ate. <br /> <br /> Marion County <br /> <br /> DEPT- OF BUILDING INSPECTION <br /> <br /> SALEM, OREGON 97301 <br /> <br />APPLICATION FOR PLUMBING PERMIT <br /> <br />NOTE; Applicants must hold Oregon Registration to conduct a plumhlng business [] or must be property owner/operator not <br /> <br />Job Address <br /> <br />hiring outside help E~. Indicate statue. <br /> <br /> TYPE OF PERMIT "TOTAL AMOUNT <br />Rase Price $ 5.00 <br />Reaidential <br /> <br />Kitchen Unit Includes Water Heater <br />Ba[h Unit <br />Bath Unit (half} <br />Laundry Unit <br /> <br />Miscellaneous Fixtures <br /> <br />Sewer Service Line <br /> With Plumbing Turn,around <br />Commercial <br /> <br />1 to 50 F~xtures <br /> <br />Over 50 Fixtures <br /> <br />Alterations & Additions <br /> Charged at Commercial Rates <br /> <br />Lawn Sprinkling System <br /> TO and including each protective device <br /> <br />NO,, OF ITEMS FEE ON EACH <br /> <br /> $4.00 <br /> $5,oo <br /> $3,00 <br /> <br /> $2.00 <br /> $3.00 <br /> $500 <br /> <br /> $2,,00 aa, <br /> $1,00 ea <br /> <br /> $2,00 <br /> <br />TOTAL AMOUNT ALL ITEMS <br /> <br />SURCHARGE <br /> <br />GRAND TOTAL <br /> <br />I certify that all plumbing work will be done in accordance with applicable provisions of Oregon Revised Statutes Chapters 447 <br />and 693 and applicable codes, and that no help will be employed unless licensed under ORS 693. <br /> 2 ....... <br /> <br /> Return Complete Application With the Ind'ca ed <br /> <br /> <br />