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Application Received <br />Da,e ,, 2 <br />Application Approved <br /> <br />By <br /> <br /> Marion County <br /> <br />DEPT. OF BUILDING INSPECTION <br /> <br />COURT HOUSI;, SALEM, OREGON <br /> <br />PLUMBING II~S~ALLATION <br /> <br />Permit Fee /~ <br />Receipt No ~t,~-// <br /> <br />Address <br /> <br />Address <br /> <br />Phone __ <br /> <br />APPLICATION TO INSTALL <br /> <br />Water Closets No, . ¢~ <br />Bath (tub) No. / <br />Basins No. ,~_~ <br /> <br />Rain Drains No .............. <br />Sinks No, / <br />Laundry Trays No. <br />Garbage Disposal No,, <br /> <br />Drinking Fountains No, <br /> <br />Shower Baths No. <br />Wash Racks No. <br />Drains, Stable No. <br />Drains, Garage No. <br />Drains, Floor No,, <br />Dishwasher No. <br /> <br /> Urinals <br /> ,. Slop Sinks <br /> Sump Pumps <br /> Boiler Blow Off <br /> <br />/ <br /> <br />NO, I <br /> <br />NO, <br />NO,, <br />NO, <br />Refrigerator Wastes No,, <br />Automatic Washers No. <br /> <br />Water Heaters No, <br /> <br />Other Fixtures not specified above <br /> <br />'::- ..... <br /> <br />agree to <br /> <br />IAlter ~ <br /> Repair ~ the plumbing system according to the Plumbing Code of the S~te of Oregon,, <br /> <br /> Applicant <br /> <br /> <br />