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Application Received
<br />
<br />Date
<br />
<br />~OT£; App ca,ts' must
<br /> b r ~g outside
<br />
<br /> PLUMBING
<br />
<br />Job Addr.ss ~ ~
<br />
<br /> Mai;ion Cdunty
<br />
<br />DEPT. 0F.-BUILDING INSPECTION
<br /> 3180 CENTER STREET N~E.
<br /> SALEM, OREGON 97301
<br /> 5SC-E147
<br />
<br />APPLICATION FOR I~LUMBING PERMIT
<br />
<br />BIdg..,Pe, rmlt #
<br />Plbg.' P~rmit
<br />
<br />,.must be property"owner/operator not
<br />
<br />Owner Address Phone
<br />Plbg. In
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<br /> .. TYPE oF'PERMIt: ' : NO. OF ITEMS FEE ON EACH TOTAL AMOUNT
<br /> K tchen Un t nc udes Water Heater, , ' '/ .,, $5.00
<br /> Seth Unit (full) ........ '
<br />
<br />Sewer Service Line , , .: .,, '.,.$3.00
<br /> With, Plumbing Turn-aroL~nd " ,. _ '
<br /> , ,$2.00 es.
<br /> 1 to 50·Fixtures . · '
<br /> -' ., . , :, , ,. $1.00 ea.
<br />Alterations & Additions
<br />
<br /> To and including each protective device ..... '. , ' ' ~' ,, ,., , ,' ...... - ,, $2 00 , '
<br /> · ., GRAND, TOTAL.
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<br />I certify that all plumbing work will.be ·done n accofdance.w th apP cable provs OhS of Oregon Revised, Statutes Chapters 447.,
<br />and 693 and applicable codes, and,that no help wd be amp oyed un ess censed, under ORS 693,
<br />
<br />....... - ..,.............,,.....,...._.._,,...,.,/--
<br /> Retu~/~/Complete Application With the Indicated'F~.
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