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.... ] MARION COUNTY BUILDING INSPECTION <br />Received b~yf/~ ~1~. i w:/ 220 High Street N~ <br />/ ~ -- ~ ;hone 58g-5147 ~:00 ,.m.- 4~0 p.m. ~ ~: <br /> <br /> PLUMBING PERMIT APPLICATION ~: ~ss-~4s Date: <br />P/ease complete all Sections, I through 5 <br /> Issued by: <br /> <br />Perm}~ No, <br /> <br /> 1. LOCA?ION OF INSTALLAT][ON <br /> <br /> / <br />p~TS A~ NON.~N~BLE AND NON.~DABLE AND <br />~PIRE IF WO~ IS NOT STAR~ ~ I g0 DAY$ OF <br />OR IF WO~ IS 5USpBNDED FOR IS0 DAYS, <br /> <br />FOR OWNER INSTALLATIONS <br /> <br />City/State/Zip <br /> <br />3, PLAN REVIEW S~CTION <br /> <br />We will provide pl;m review service if you complete Section <br />5B m~d submit two (2) sets of plans and specifications with <br />this application~ <br /> <br />]'his optional plan review program does not suspend the <br />required submission of plans, and specifications when required <br />b~ the Oregon Structural Specialty Code, Chapter 53. <br /> <br />4(f)s-45 <br /> <br />Rev, 7/92 <br /> <br />NO. X Pigs = SUM <br /> <br /> $20.00 <br /> <br />BASE FEE <br />A, R.ESIDENTIAL <br /> <br /> S~gle Family or m~ti-Family per <br /> dwelling unit (each fixture) <br /> New construction , $ 9,00~ <br /> Alterations ,$ 9,00~ <br /> Re-located structure __, $ 4.50 <br /> <br /> Water Lines : <br /> First 100 fi. Or'fi.action ~ereof <br /> For additional 100 fr, (up to <br /> maximum o f 500 feet) -- $15,00 <br /> <br /> Sewer Lines <br /> First 100 feet or fi.action thereof $30.00 <br /> For additional 100 feet (up to <br /> maximum 500 feet) --$15.00 <br /> <br />B. COMMERCIAL (each fixture) <br /> <br /> New constructi6n __$ 9.00 <br /> ~P, emt ions --$ 9.00. <br /> Re-located structure __ $ 9.00~ <br /> <br /> Water Lines <br /> First 100 feet ox fracticm thereof -- <br /> For additional 100 feet $15.00---- <br /> <br /> Sewer Lines <br /> First 100 feet or fraction thereof __ $30,00~ <br /> For additional I00 feet --$15.00~ <br /> <br /> C, LAWN SPRINICLER SYSTEM <br /> E, ch protective backflow device [ .$ 4.50 ~ <br />D. OTHER (as rec~u_ked by OSPSC and <br /> Building Offimal) <br /> <br />5, FEES Al. Enter total of fees from Sec, <br /> A2. Add 5% surch~ge (.05 x Al) <br /> <br /> $ <br /> <br /> Subtotal $ ~ .~-.~ ~ <br />B. Enter 25% of line AI for P[~ Revi~ <br /> (.25 x Al) if req~red <br /> D.C' investi~tion~n~e(ifroquired) $$ ~ <br /> <br /> <br />