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PLUMBING PERMIT APPLICATION <br /> <br />~,~wner: ' Mai lng Address:, <br />.. , - b 2,5-o <br /> Job Add,ess: ~ ~ .~ Sl~ No.: Cross Street: <br />~~~~ Phone: .... Add~s~; <br />~'~ Registration NO.: "' <br />Residential: ~ New: ~ ' ' <br />Addition; ~ Occupancy Use of Building: <br /> Commercia]: ~ ...... Alterat[on; ~ , ,, Relocation: ~ Cha~ge: ~ ~ ~_~/~~~ ~ <br /> <br /> NO. FEE AMOUNT <br /> Rase Price <br /> Residential <br /> ...... New construction (each fixture $ 9.00 <br /> Alterations (each fixture) 9,OO <br /> .Re-located Residence each fixture) 4.50 <br /> Commercial <br /> . . New Construction (each fixture) 9.00 <br /> Alterations (each fixture) ..... 9.00 <br /> <br /> For additionat 100 feet 15.00 <br /> Sewer Service Lines <br /> <br /> Additional 100 feet 15.00 <br /> <br /> (maximum 5 feet length) .... . 25.00 <br /> Other (a~ per OSP. SC and Building Official) · <br /> On-Site Technical Review (apply et Marion County only) <br /> Re-Inspection Fee .... ' ' ' 25.00 <br /> FEE <br /> STATE SURCHARGE <br /> PLAN REVIEW FEE $ <br /> <br />Please return COMPLETE APPLICATION ' FLEET SURCHARGE $ <br />with the indicated fee. C~T¥ FEE $ <br /> TOTAL $ <br /> <br />~ am a registered builder OR- - the authorized reereeent~tive el SIGNATURE OF APPLICAN~ <br /> <br /> work will be performed by a registered builder. <br />Other. <br /> <br />MC15~ <br /> <br /> <br />