Laserfiche WebLink
MARION COUNTY BUILD]lNG INSPECTION <br /> <br />PLUMBING PERMIT APPLICATION <br />P/ease complete all Sections, 1 through 5 <br /> <br /> 1. LOCATION OF INSTALLATION <br />Job Address ~~,, , ~, <br />,City ] Cross St, <br />Directions <br /> <br />PERMITS ARE NON. TRANSFEKABL£ AND NON.1LEFUNDABLE AND <br />EXPIPJ3 IF WORK IS NOT STARTED WI]lIEN 180 DAYS OF ISSUANCE <br />OR iF WORK IS SUSPENDED FOR I S0 DAYS. <br /> <br /> 2A. CONTRACTOR INSTALIakTION ONLY <br /> <br />Co,tracers Licen~ No, <br /> <br />Contraetogs Boar~ Rog, No- [Iob No, <br /> 2a, FOR OWNER INSTALLATIONS <br /> <br />Mailing Address l Phone <br /> <br />The installation is being ma~le on property I own which is not intended for sale, <br />lease, or rent. <br /> <br />3. PLAN REVIEW SECTION <br /> <br />We will provide plan review ~ervice if you complete Section <br />5B and submit two (2) sets of plans and specifications with <br />this application. <br /> <br /> This optional plan review program does not suspend the <br /> required submission of plans, and specifications when required <br /> by the Oregon Structural Specialty Code, Chapter 53. <br /> <br /> IC ]J-dj <br />Rev~ 2/92 <br /> <br /> 220 High S~reet NE <br />Salem, Oregon 97301 <br /> <br />~de-A-~oue: 588-7904 <br /> F~: 58S-7948 <br /> <br />BASE FEE <br />A. RESIDENTIAL <br /> <br />Single Family or multi-Family per <br />dwelling unit (each fixture) <br /> New construction <br /> Alterations <br /> Re-located smmture <br /> <br />NO, X FEE = SEM <br /> <br /> $20.00 <br /> <br />--, $ 9.00 <br />--.$ 9.00 <br />__ $ 4.50 ........ <br /> <br />Water Lines <br />First 100 ft. or fraction thereof __.$20,00 <br />For additional 100 ft. (up to <br />maximum of S00 feet) __.$15.00 <br /> <br />Sewer Lines <br /> First 100 feet or fi.action thereof <br /> For additional 100 feet (up to <br /> maximum 500 fee0 <br /> <br />B. COMMERCIAL (each fixture) <br /> <br />__,$30.00 <br /> <br />__,$15,00 <br /> <br />New construction $ 9,00~ <br />Alterations / $ 9.00 <br />Re-located structure $ %00__ <br /> <br />Water Lines <br /> First 100 feet or fraction thereof <br /> For additional 100 feet <br /> <br />--$20.00-- <br />--$15,00 <br /> <br />Sewer Lines <br />First 100 feet or fraction thereof $30,00.__ <br />For additional I00 feet __$15.00 <br /> <br />C, LAWN SPRINKLER SYSTEM <br /> <br />Each protective backflow device <br /> <br />D, OTHER (as recruited by OSPSC and <br /> Building Offictal) <br /> <br />--$ 4,50 <br /> <br /> 5. FEES ~ <br /> Al. Enter total of fees from Sec. # 4 - <br /> A2, Add 5% surcharge (.05 xA1) $ <br /> <br /> Subtotal $ ,2~/J, t/~-'-- <br />B, Enter 25% of line A1 for Plan Rcwiew <br /> (,25 x Al) if reoulred $ <br />I C. Investigation Fee(ifrequi~ed) $ <br /> <br /> TOTAL AMOUNT DUE $ ~'/, ~ (¢ <br />L~e~e ~t No. ,g& q 7 <br /> <br /> <br />