Laserfiche WebLink
I~ecelved By:: ' <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> Senator Bldg. NO,, 225 <br /> 220 High saY, et NS <br /> Salem, Oregon 97301 <br /> <br /> PhOne 588~5147 <br /> Code-A-Phone 4:30 RM. - 8:00 A.M. <br /> <br />PLUMBING PERMIT APPLICATION <br /> <br />Owner:: Phone:: M,~i[ing Address <br />Job Address - Site No..;; Cross ~,~at :: <br />qq - l ...... <br />Plu~bi~9 Installer:: ~ . Phone:: Address:: , <br />Home Builder~ Registration No,,;; ] <br /> <br />Residential;; ~ New;: ~ Addition':: ' ' ' '"~"' Occupancy Us~ of Building:: ', ...... <br />Commemlal ~ Alteration:: ~ Relocation; ~ Change:: ~ ~ ~..~.. <br /> <br /> NOt FEE AMOUNT <br />Base Price $20.00 <br />Residential <br />; New construction (each fixture) ........... .~ ....... $ 9.(~ ~ ,.~, 00 <br />Alterations (each fixture) 9.00 <br />Re-located Residence (each fixture) 4.50 <br />Commercial <br />New Construction (each fixtu?! ......... 9.00 ....... <br />Alterations (each fixture) 9 00 <br />Water Lines <br />For the first 100 feet or fraction thereof 20,00 <br />For additional 100 feet 1500 <br />Sewer Service Lines <br />First 100 feet ir fractioe ih~i ..... 30 O0 <br />Additional 100 feet 1500 <br />Mobile Home sewerhvater connection <br />(maximum 5 feet length) 25.00 <br />Other (as per OSPSC and Building Official) <br /> On-Site TechnicaI.R~ .vi~.!.~.p.P.!Y at Marion County only) ............ <br /> Re-inspection Fee 25.00 <br /> FEE $ ~.~_~ ~ <br /> STATE SURCHARGE <br /> PLAN REVIEW FEE $ <br /> INVESTIGATION FEE <br />Please return COMPLETE APPLICATION FLE6T SURCHARGE <br />with the indicated fee, CITYTOTALFEE. $..~7~ <br /> <br />t{~ lamperformingworEonaproper, lownorcccupy ~T/~/~ /'~ <br /> lam~reglstere~lbuilclerOR( )theauthori~edrepresentatlveof SIGNATUREOFAPPLICA : / l/~ ~-/ <br /> <br /> e registered builder <br />( ) The work will be psdormed by a registered buildar <br />( ) Other. <br />( ) l agree to install acco~ing tOthe submitted plans and specdicatior~s= the lawsofthest~teofOregonandtheordinanceaof MarionCounty <br /> <br />Rev. 12J87 <br /> <br /> <br />