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MARION COUNTY BUILDING INSPECTION <br />Senator Bldg. NO,, ~9,5 <br />220 High Street NE <br /> Salem, Oregon 97301 <br /> <br /> Phone 588-5147 <br /> Code-A-Phone 4:30 EM. - 8::00 A.M~ <br /> <br />PLUMBING PERMIT APPLICATION <br /> <br />.......... ~hone:: Mai~g Ad~re~'~:: <br />· Site No..:: Cross <br />Home Bulld~r~ ~ictr~tion NO:: ' ........... <br /> <br />~esidectial:: ' ~" New:: ~ Add'ion:: ~ O~up~n~ Use et ~ildin~:: , <br />Comme~tal;: ~ ........ Alteration: ~ Relocation:: ~ Change:: ~ <br /> <br />7 <br /> <br /> NO FEE AMOUNT <br /> Sase Price .................... $20..00 <br /> Residential <br /> Newconstruction each"iixture . . J'~, " ...... $ 9.00 /,:g~/~ z~"' <br /> Al!~.~atlons (each fixture) g00 <br /> <br /> :Re-located Residence leach fixture) ............ ' ...... 4..50 .... ' .... <br /> Commercial <br /> New Construction ~ash fixture) 9..00 ........ <br /> Alterations (each fixture) ............. 9.00... <br /> Water Lines ......... <br /> For the first '1'00 feet or fraction ther~ 2~..00 <br /> For additional 100 feet 15,00 <br /> Sewer Service Lines <br /> First 100 feet or fraction thereof 3~.'.~0 <br /> Additional 100 feet 1500 <br /> Mobile Home sewer/~vater connecti~)'n .... <br /> (max?um 5 feet length) 25".0'0 <br />Oth~r.!.as per OSPSC and Buil~.ing"Offlcial) ...... <br />._?.On-Site Technical Review .apply at Marion Countyon!¥) <br />Re-inspection Fee 2500 <br /> <br />STATE SURCHARGE <br />PLAN REVIEW FEE $ <br />INVESTIGATION FEE $ <br />Please return COMPLETE APPLICATION FLEETSURCHARGE $ ,.~'. <br />with the indicated fee. C~TY FEE $ <br />TOTAL ~ <br /> <br />( ) lemsregisteredbuildetOR( )theauthorlzedrepresentativeof $1GNATUREOFAPPLICANT <br /> a registered builde~ <br />(~) Thework~illbeperformedbyaregiste~dbuilger ,~ ~ ~-~ ~ ~g~ <br />( ) Other <br />(~") I agree to Install according to the submitled plans and apecificatiens~ the laws of the state of Oregon and the orciinances of Marion County <br /> <br />, ,:' MC t5-45 <br /> <br /> <br />