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Re&ive~ [ 220 High Street NE <br />Date: I S em, O go 97 0 <br /> <br />Please complete all Secffons, 1 through gl- 5~,~0 1 5 199A ~5~ued ~y: <br /> <br />I, LOCATION OF INSTALLATION <br /> <br />OR IF WOKK IS SUSPENDED PeR 180 DAYS, <br /> <br />MARION <br /> <br />lA, CONTRACTOR INSTALLATION ONLY <br />Contractor I Phon= <br /> <br />Propenty Owner [ Phone <br />Plumbing Board: <br />Contractors Board Reg, NO. { lob No, <br />Joumeyman'~ Plulnbefs No. <br /> <br /> 2B. }'OR OWNER INSTALILd*,TIONS <br /> <br />City/State/Zip ~ <br /> <br /> 3. PLAN REVIEW SECTION <br /> <br />We will provide plan ~eview service if you complete Section <br />5B and submit two (2) sets of plans and specifications with <br />this application. <br /> <br />This optional p]an 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 />Rev, 7/92 <br /> <br />BASE FEE <br />A, P,~SIDENTIAL <br /> <br />Single Family or multi-Family per <br />dwelling mt (each fixture) <br /> New construction <br /> Alterations <br /> Re-lonsted structure <br /> <br />Water Lines <br /> First 100 fl, or fraction thereof <br /> For additional 100 fir. (up to <br /> maximum of 500 feet) <br /> <br />Sewer Lines <br /> First 100 fe~ or fraction thereof <br /> FOr additional 100 feet (up to <br /> maximum 500 feet) <br /> <br />COMMERCIAL (each fixture) <br /> <br />$20.00 <br /> <br /> -.. $9.00 <br /> ........ $ 9.00 <br /> $ 4.50 ~ <br /> <br /> _ $20.00 <br /> ~$15,00 <br /> <br />~$30.00 <br />__$15.00 <br /> <br />New constmcti6n $ 9.00.__ <br />Alterations -- $ 9,00 <br />Re-located sUmcture _ $ 9.00.__ <br /> <br />Water Lines <br />First 100 feet or fraction thereof --$20.00-- <br />For additional 100 feet --$15.00 <br /> <br />Sewer Lin~s <br />Fkst 100 feet or fraction the, roof $30.00 <br />For additional 1 O0 feet -- $15.00 <br /> <br />C, LAWN SPKINKLER SYSTEM <br /> <br />Each protective backflow device <br /> <br />D. OTHER (as required by OSPSC and <br /> Bu/lding Officml) <br /> <br />4.50-- <br /> <br /> Al. Enter total of fees from Sec, # 4 <br /> A2, Add 5% surcharge 605 x Al) $ <br /> <br /> Subtotal $ <br />B. Enter 25% of line A1 for Plall Review <br /> (,25 xA1) if reqUlrcd $ <br /> C, Investigation FeeOfrcqulredk $ <br /> D. RcinspectionFee C~'~F~ $ 46700 <br /> <br /> <br />