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MARION COUNTY BUILDING INSPECTION <br />'=enator Bldg. No, 22~ <br />220 High Street NE <br /> <br />PLUMBING PERMIT APPLICATION <br /> <br />./er ',, Ph0ne~ M.~llln9 Address~ ~, '" <br />P~m~g Installer ~ ~ '" Phone:: Address',:" / <br />Home Builde~ Registration ~ I <br /> <br /> Residential:: ~' New;; ~ 'Addition:: <br /> Com~eroiar ~ Alteration: ~ Re[oca~on:: ~ ..... <br /> <br />AMOUNT <br /> $2000 <br /> <br />Sase Price <br />Residentiar <br /> New construction (each fixture) <br /> Alterations (each fixture) <br />Re-located Residence (each fixture) <br />Commercial <br /> <br /> New Construction (each fixture) <br />Alterations (each fixture) <br /> <br />Water Lines <br /> <br />For the first t 00 feet or lraction thereof <br /> <br />For additional 100 feet <br /> <br />Sewer Service Lines <br /> <br />First 100 feet or fraction then~of <br /> <br />Additional 100 feet <br /> <br />Mobile Home sewerhNater conrlecfion <br /> <br />(maximum 5 feet length) <br /> <br />Other (as per OSPSC and Building Official) <br /> <br />I On-Site Technlcal Review (apply st Marion County only) <br /> Re-Inspection Fee <br /> <br />NO FEE <br /> <br /> $ 900 <br /> 9 00 <br /> 450 <br /> <br /> 9,00 <br /> 900 <br /> <br /> 2000 <br /> 15.00 <br /> <br /> 30,00 <br /> 15,00 <br /> <br /> 25 00 <br /> <br />25,00 <br /> <br /> FEE <br />STATE SURCHARGE <br />PLAN REVIEW FEE <br />INVE~;TIGATION FEB <br /> <br />$ <br />$ <br /> <br />Please return COMPLETE APPLICATION <br />with the indicated fee, <br /> <br /> I am performing work on a property I own or occupy <br />('~/--).._1 ~m a registered builder OR ( ) the asthorlzed reprasentstive of <br /> <br /> The work will be performed by a registered builder <br /> Other <br /> <br />FLEET StJRCHASGE ~ <br /> CITY FEE ~p..._ <br /> <br />) I agrae to install a~cording to the submitted plans and speciflcstlor]s, the laws of the state of Oregon and the ordinances of Marion County <br /> <br />MC 15-45 <br />Rev 12~87 <br /> <br /> <br />