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Date: <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> Senstor BIdg, NO, 225 <br /> 220 High Street NE[ <br /> Salem, om~jon 97301 <br /> <br /> Phone 58B-5147 <br /> Code-A-Phone 4:30 RM. - 8=00 A.M, <br /> <br />PLUMBING PERMIT APPLICATION <br /> <br /> Site No.; Cross $~reet: <br />'" PIumblng I~ller; Phone: Address: <br />Home Ballder~ Registration NOJ <br /> <br /> Residential: ~ ' New: ~ Addid0n: ~ Occupancy" ~ ~seofBal~dJn~ <br /> <br /> NO. FEE AMOUNT <br /> Se, se Price $20,00 <br /> Residential <br /> New construct!on (each fixture) $ <br /> Alterati?ns (each fixture) ~),O0 <br /> Re-located Residence, (each fixture! 4,50 <br /> Commercial <br /> New Constructioq,,!each fixture) , 9.00 <br /> Alterations (each fixture) 9,00 <br /> Water Lines <br /> For the first 100 feet or f~action thereo¢' ' / ,, 20.00 <br /> For additional 100 feet 15,00 <br /> Sewer Service Lfnes <br /> First 100 feet or fractier~ thereof ,/ 30.00 <br /> Additional 100 feet 15,00 <br /> Mobile Home sewer/ware~ connection" <br /> (maximum 5 feet lena!h) 25,00 <br /> Other (as per OSPSC and Building Official) <br /> .,On-Site Tec~ nical Review (apply at Marion Couaty only) <br /> Re-lnspe,cticn Fee , 25,00 <br /> STATE SURCHARGE <br /> PLAN REVIEW FEE $ <br /> INVESTIGATION FEE $ <br />Please return COMPLETE APPLICATION FLEET SURCHARGE $ '~. {~/7/ <br />with the indicated fee. CITY FEE <br />TOTAL <br /> <br />(/,"') lamaregisteredbuilderOR( )tbe~uthodzedmpmsentatl~of SlGNATUREOFAPPLICANT- <br /> <br />(~) T~e work wl~t be ~ed~med ~ ~ ~iste~ b~er. ~ <br />( )~het~ Ifl <br /> <br />MC <br />Rev. 12/87 <br /> <br /> <br />