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MARION COUNTY BUILDING INSPECTION <br /> <br />220 High S~reet NE <br />Salem, Oregon 97301 <br /> <br />Phone $SS-$147 8:00~m.- 4:30 p.m. <br />Code-A-Phone:SSS-7904 <br />FAX:SSS-794S <br /> <br />PLUMBING PERMIT APPLICATION 5 <br />Please complete all Sections, 1 through <br /> <br />SITE #: <br /> <br />Date: <br /> <br />Issued by: <br /> <br />Permit No, <br /> <br />1, LOCATION OF INSTALLATION <br /> <br />PEP, M/TS ARE NON.TRANSFERABLE AND NON-R~FUNDABLE AND <br />F. XPIRE IF WORK IS NOT STARTED WITHrM 180 DAYS OF ISSUANCE <br />ORIF WOR~ IS SUSPENDED POR 18o DAYS. <br /> <br /> 2A. CONTRACTOR INSTALLATION ONLY <br /> <br />Contractors Board ReS, No, [ Job No. <br /> <br />FOR OWNER INSTALLATIONS <br /> <br />Mailing Address <br /> <br />City/$t~/Zip <br /> <br />Phone <br /> <br />3. PLAN REVIEW SECTION <br /> <br />We will provide plan review service if you complete Section <br />513 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 />2/92 <br /> <br />4. FEE SLZltEDUI~ (Complete and eater total m A1 below) <br /> [] RESIDENTIAL [] COMMERCIAL <br /> UsE OF STRUCTORE; [] <br /> NEW [2ALTERA2qON [] ~Dm~ON [] ~ELOCA~O~ [] <br /> <br />NO. XFEE -SUM <br /> <br />BASE FEE <br />A. RESIDENTIAL <br /> <br /> Single Family or multi-Family per <br /> dwelling unit (each fixtme) <br /> New construction <br /> Alterations <br /> Re-located structure <br /> <br /> Water Lines <br /> First 100 R. or iraction thereof <br /> For additional 100 ir. (up to <br /> maximum of S00 feet) <br /> <br /> Sewer L/nes <br /> First I00 feet or fraction thereof <br /> For a. dditiona1100 feet (up to <br /> maxtmum 500 feet) <br /> <br />B. COMMERCIAL (each fixture) <br /> <br /> New construction <br /> Alterations <br /> Re4ocated structure <br /> <br /> · Water Lines <br /> First 100 feet or fraction thereof <br /> For additional 100 feet <br /> <br /> Sewer Lines <br /> F~t 100 feet or fi'action thereof <br /> For additional 100 feet <br /> <br />C. LAWN SPRINKLER SYSTEM <br /> <br /> Each protective baekflow device <br /> <br />D. OTHER (as required by OSPSC and <br /> Building Official) ;; <br /> <br />$20,00 <br /> <br />--.$ 9.00 <br />--.$ 9.0O <br />__$ 4.50 <br /> <br />--$20.00 <br /> <br />--$15.00__ <br /> <br />__$30,00, <br /> <br />--$15.00 ,,, <br /> <br />9,002 <br />9.00__ <br />9.00 <br /> <br />--$20,00 <br />--$15.00 <br /> <br />__$30.00 <br />__$15,00 <br /> <br />--,$ 4,50, <br /> <br />FEES <br />Al. Enter total of fees from Sec. # 4 <br />A2, Add 5% surcharge (,05 x Al) <br /> <br /> Subtotal $ <br />B, Enter 25% of line A1 for Plan Review <br /> (.25 x Al) if recruited $ <br /> C. Inwstigation Fee[if r~qdired) <br /> $ <br /> D, Reinspection Fee $ <br /> R¢¢¢!p' No-'~~- IOi'F'~ <br /> <br /> <br />