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~'Recslved <br /> <br /> Date: <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> <br /> 220 High Street NE <br /> Salem, Oregon 97301 <br /> <br /> Cod~A-Phone 4:30 RM: ~ 8:00 A,M. <br /> <br />PLUMBING PERMIT APPLICATION <br /> <br />Owner: , Mailing Ad.~ress: .... <br /> <br />dobAddmss: ~ / Si~ NO.: Cro~ 8trep~ <br /> <br />Pluming I~ller:. ~. . Phone: Address: <br />Home ~uilder~ Registration No.: <br /> <br /> NO. FEi~ AMOUNT <br /> Base Price $20,00 <br /> Residential <br /> New construction (each fixture) ,, '/7 ' $ 9.00 <br /> Alteratio0s (each fixture) 9,00 <br /> Re-located Residence (each fixture) : 4.$0 <br /> New Cons[ruction (each fixture) 9.00 <br /> Alterations (each fixture 9,00 <br /> =WaterLines <br /> For the first 100 feet 0r fraction thereof 20,0~ <br /> For additional 100 feet 15.00 <br /> Sewer Semite Lines <br /> F rst 100 feet or fract on thereof 30,00 <br /> Additional 100 feet: 15.00 <br /> Mobile Home ~ewer/water connection <br /> : ](maximum 5:feet ength) 25.00 <br /> Other (as per OSPSC and Building Official) ;, , , . ., <br /> On-Site TeChnical Review (apply at Marion County only) <br /> Re-Inspection Fee 25,00 <br /> i: STATE SURCHARGE ~;/~'-' <br />PLAN REVieW FEE $ · <br />INVESTIGATION FEE $ <br />Please return COMPLETE APPLICAT ON FLEETSURCHARGE ' $ <br />with the indicated fee. ' CITY, FEE <br /> <br /> m a registered builder OR ( <br /> bullde~ <br /> <br />Other <br /> <br />] I agree to Install according to the subm~tteo clans an~l ssecificetions, the laws of the 8fete of Oregon ai~, he ordinances of Marion Coan[y, <br /> <br />MC 15-4~ <br />Rev, 12J87 <br /> <br /> <br />