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PLUMBING PERMIT APPLICATION <br /> <br />Owner;: Phone:: Mailing Address:; <br />Jo'l~Addre~s,/~, .._.~__.~Z~--J~.L~ .~.~.. SifeNo Cro88Street:: <br />Plumbing Installer:: Phone:: Address:: <br /> <br />Residential,' ~ New:: ~ ....... Addition;; [] Occupancy I 'U'seofBuilding;; <br />Change:: [] I <br />Commercial;; [~ ~,,[!O?~fioe:: [] Relocation:: [] ......... <br /> <br /> NO FEE AMOUNT <br />Ease Price $2000 <br />Residential <br />New construction (each fixture) $ 900 <br />Alterations (each fixture) gO0 <br />Re-located Residence (each fixture) 4,50 <br />Commemlal <br />New Conatru~tion (each fixture) 9.00 <br />Alterations (each fixture) 9,00 <br /> <br />Water Line8 <br /> For the first 100 feet or fraction thereof 2000 <br /> <br />For additional 100 feet 15,oo <br />Sewer Service Lines <br />First 100 feet or fraction thereof 3000 <br />Additional 100 feet 15 00 <br /> <br />Mobile Home sewer/water connection <br /> (maximum 5 feet length) <br /> <br />Other (es per OSPSC and Building Official) <br /> <br />On-Site Technical Review (apply at Marion County only) <br />Re-inspection Fee <br /> <br />Please return COMPLETE APPLICATION <br />with the indicated fee,, <br /> <br />J sm perfermlng work on a property I own or o~eupy <br />I am a registered builder OR ( ) the authorized representative of <br />a registered builder, <br />The work will be performed b,j a registered builder <br />Other <br /> <br />SIGNATURE OF APPLICANT <br /> <br />25,00 <br /> <br /> 2500 <br /> FEB <br />STATE SURCHARGE <br /> PLAN REVIEW FEE <br />INVESTIGATION FEE <br />FLEET SURCHARGE <br /> CITY FEE <br /> TOTAL <br /> <br />~ l agree to install a¢co~dingtothe submitted plansandspecifications: the lawsofthestateofOregon and theo~dlnancesof MArion County <br /> <br />MC lS-4S <br />Rev, 12/87 <br /> <br /> <br />