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~/ .~ ,~,/*~,, MARION COUNTY BUILDING INSPECTION <br />Received By: / {/%// V~(J yrL~YC ~nator Bldg. No, ~ <br /> <br />PLUMBING PERMIT APPLICATION <br /> <br />Western Fireworks Inc. Ph[?~_2D78 I~a~i~g.Add~e¢~ 426 Aurora OR 270C <br />¢el:lA~: Ottaway Rd NE SiteNo,: ~r~:y ~E NE <br />elu¢~i~stal~umbin~ P~¢L2091 '' 9¢~S:NE 4th Av~. <br /> <br /> FEE AMOUNT <br />Base Price $20.00 <br />Residential <br />New construction, each fixture, <br />Alterations. each fixturej <br /> <br />Re-located Residence (each flxtu~7 <br />Commercial <br /> <br />New Construction ,each fixture <br /> <br />Alterations [each fixture- <br /> <br />Water Lines <br /> <br />For the first 1 O0 feet or fraction thereof <br /> <br />For additional 100 feez <br /> <br />Sewer Service Lines <br /> <br /> First 100 feet or fraction thereof <br /> Additional lOO fee[ <br />Mobile Home sawer~ater connection <br /> ~mextmum 5 feet length) <br />Other (as ear OSPSC and ~Uilding Official) <br />On-Site Technical Review (apply at Marion County only) <br /> <br />Re-inspection Fee <br /> <br />Please return COMPLETE APPLICATION <br />with the indicated fee. <br /> <br />NO <br /> <br /> $ 9.00 <br /> 9,00 <br /> 4.50 <br /> <br /> 9.00 <br /> 9,00 <br /> <br /> 20.00 <br /> 15.00 <br /> <br /> 30,00 <br /> 15,00 <br /> <br /> 25,00 <br /> 25,00 <br /> <br /> FEE <br />STATE SURCHARGE <br />PLAN REVIEW FEE <br />INVESTIGATION FEE <br />FLEET SURCHARGE <br />CITY FEE <br /> TOTAL <br /> <br />$ ~6.00 <br /> I.~ <br />$ -0- <br /> <br />J em a registered builder OR ( ) the authoezed representative of SIGNATURE OF APPLICANT: <br />a registered builder, <br />The work Will be performed by a registered builder, <br />Other <br />I agree to in~ta[I according to t~ submitled glans and specifications, the laws of the state of O~gon and the ordinances of Marion County, <br /> <br />MC 15,45 <br />Rev. 12/87 <br /> <br /> <br />