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Received By;: <br /> <br />Date,,,,, <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> Senator Bidg,, No. 225 <br /> 22[3 t-ligh ~t~eet <br /> Salem, Oregon 97301 <br /> <br /> Phone 588-5147 <br /> Code-A.Paone 4~0 P,M, - 8:00 <br /> <br />PLUMBING PERMIT APPLICATION <br /> <br />.......... p,h~iI Mail%9 Add'~SS' <br />Job Address' Site No,;; Cross St~et:~. <br /> , ...... <br />umg Installer;~ Phone: Address <br />Home BuJlder~ Registration NO¢ <br /> <br /> Residential' ~ New:: 0 ~ddltion;: O .... ~'ccupancy O~ of Building':: ' <br /> Commercial ~ ,, Alteration ~ .... Relo~tion:: ~ Change:: ~ ~/~ <br /> <br /> NO, FEE AMOUNT <br /> Base Price $2000 <br /> Residential <br /> New construction (each fixtLI;~} .... $ 9,,00 ....... <br /> Alterations (each fixture 9,,00 <br /> Re-located Besidence (each fixture) 480 <br /> Commercial <br /> New Con~!ruction ieech fixture) 900 "' <br /> Altera!!ons (each fixture) ,,, 9 00 <br /> Water Lines <br /> For the fir~i 100 feet or fraction thereof ...... 20 00 .... <br /> For additional 100 feet 1500 <br /> Sewer Service Lines <br /> First 100 feet or fract'i'on thereof $'0,00 <br /> Additional 100 feet 1500 <br /> Mobile Home sewerAvater connection <br /> (maximum S feet length) / 25 O0 <br /> Other (as per O~P$C and Building Official) <br /> On-Site Technical Review (app'{y at Marion County'only) <br /> Re-inspection Fe9 ...... 95.00 <br /> <br />STATE SURCHARGE /~ ~ ..~ <br />PLAN REVIEW FEE $ <br />INVESTIGATION FEE $ <br />Please return COMPLETE APPLICATION FLEET SURCHARGE $ <br />with the indicated fee, CITY FEE <br />_TOTAL $ <br /> <br />6/~1 ara performing work on a property I own or occupy ~,._ t <br /> I am a registered builder OR ( ) tl~e authorized represe~ltafive of $1G NATURE OF APPLICANT' ~v~ ~-Z~/ ~' <br /> <br />MC 15-45 <br />Rev 12/87 <br /> <br /> <br />