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f' WI MARION COUNTY BUILDING INSPECTION <br /> <br /> ' Phone ~Sg-5]~g~o ~ ~ 4:30 p,m, ~iTE ~ <br /> ......... , ~dc- <br />PLUMBING PERMIT APPLICATION <br />P/ease complete all Sections, I through 5 , n <br /> <br />1. LOCATION OF INSTALLATION <br /> <br />pFelLMI'I'$ ARE NON-~N~L~ AND NON-~DA~E AND <br />~ ~F WO~ ~ NOT ST~ W~ 180 DAYS OF ~8U~CE <br />OR IF WO~ IS SUSpeNDED FOR 180 DAYS, <br /> <br />CONTRACTOR INSTALLATION ONLY <br /> <br />Maillu$ Ad, dross <br /> <br />, Phone <br /> <br />property O~ner <br /> <br />Phone <br /> <br />lob No. <br /> <br />2B FOR OWNER INSTALLATIONS <br /> <br />The iashallation is being ~e on prope~ I own which is ~ot intended for ~le, <br /> <br />REVIEW SECTION <br /> <br />4. FEE S~JIiI~DULE (Complete and enter total in A1 below) <br /> [] R~SIDENTIAL [] COMMERCIAL <br /> UsE OF S'l~U~: [] <br /> <br />BASE FEE <br />A. RESIDENTIAL <br /> <br /> Single Family)r multi-Faraily per <br /> dwelling unit (each fixture) <br /> New construction <br /> Alterations <br /> Re-located structure <br /> <br /> Water Lines <br /> First 1 O0 t, or fraction thereof <br /> For additional 100 R. (up tO <br /> maximtma of 500 feet) <br /> <br /> Sewer Lines <br /> First 100 feet or fi'action thereof <br /> For additional 100 feet (up to <br /> maximum 500 feet) <br /> <br />B. COMMERCIAL (each fixture) <br /> <br /> New construction <br /> Alterations <br /> Re-located structure <br /> <br /> Water Lines <br /> First 100 feet or fraction thereof <br /> For additional 100 feet <br /> <br /> Sewer Lines <br /> Ffr~1100 feet or fraction thereof <br /> For additional 100 feet <br /> <br /> L~WN SPRINKLER SYSTEM <br /> Each protective backflow der/ce <br /> <br /> OTHER (as required by OSPSC and <br /> Building Official) <br /> <br />NO. XFEg -SUM <br /> <br /> $20.00 <br /> <br />--$9.0O <br /> $ 9.00 <br />__$ 430, <br /> <br />--$15,00 <br /> <br />$30,00~ <br /> <br />$15,00.~ <br /> <br />9.00__ <br />9,00 <br />9.00 <br /> <br />--$20.00 <br />--$15.00 <br /> <br />..... $30,00.__ <br /> $15.00 .... <br /> <br />--$ 4.5o,,, <br /> <br />We will provide plan review service if you complete Section <br />5B and submit two (2) sets of plans and specifications with <br />this application. <br /> <br />TMs optional plan review program does not smqpend the <br />required submission of plans, and specifications when required <br />by the Oregon Stractural Specialty Code, Chapter 53, <br /> <br />~CIJ-4J <br /> <br />Rev, 2/92 <br /> <br />5. I~E$ <br />Al. Enter total of fees from Sm, # 4 <br />A2, Add 5% surcharge (.05 x Al) $ <br /> <br /> Subtotal $ <br />B, Enter 25% of line A1 for Platt Review <br /> . (.25 x Al) ~req~lh'ed $ <br /> C, Investigation _~ee Of required) $ <br /> D, Reimpection Fee <br /> <br /> <br />