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IPLUMBING PERMIT APPLICATION <br /> P/ease complete all Sections, I through 5 <br /> <br />Phone 588-5147 8:~ ~m, ~ 4:30 p.~ SiTE ~: <br /> ~A-Pbo~: 58~ 7~04 <br /> I F~: S8S-7948 D~e: -..~RION COUNTY <br /> UUlLU~NG INSPECTION <br /> I~ued <br /> <br />1. LOCATION OF INSTALLATION <br /> <br />PE~TS A~ NON-~NSF~B~ AND NON-~DA~ AND <br />~P]~ IF WO~ IS NOT STARED ~ I ~0 DAYS OF ~SSUANCE <br />OR IF WORK IS SU$p~NDED FOR ~ ~0 DAY& <br /> <br />FOR OWNER INSTALLATIONS <br /> <br />Mailing Address } Phone <br />City/State/Zip <br /> <br />The installation is being made on pwl~erty I o,~fn which is not intended for ~ale, <br /> <br />We will provide plan review Service 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 />4C ff5-45 <br />Rev. 7/92 <br /> <br />4. FEE SCHEDULE (Complete and eater total in A1 below) <br /> [] RESIDENTIAL ~ COMMERCIAL <br /> UsE OP STRXJC'I'tr~: [] <br /> <br />BASE FEE <br />A, RESIDENTIAL <br /> <br />NO, XFER -SUM <br /> <br /> $20.00 <br /> <br />Single Family or multi-Family per <br />dwelling unit (each fixture) <br />New construct/on -- $ 9.00 , <br />Alterations --$ 9.00 <br />Re-located slimctore ~ $ 4.50 <br /> <br />Water Lines <br /> First 100 R, or fraction thereof <br /> For additional 100 R. (up to <br /> maximum of 500 feet) <br /> <br />Sewer Lines <br /> First 100 feet or fraction thereof <br /> For additional 100 feet (up to <br /> maximum 500 feet) <br /> <br />B, COMMERCIAL (each fixture) <br /> <br />/..$2o,oo2~.~ <br /> <br />$15.00-- <br /> <br />. $30.00 ,,. <br /> <br />__$15.00~ <br /> <br />New constructi6n ~$ 9.00 .,. <br />Alterations --$ 9,00 .... <br />Re-located structure __$ 9,00.__ <br /> <br />Water Lines <br />First 100 feet or fraction thereof --$20,00 <br />For additional 100 feet --$15,00 , <br /> <br />Sewer Lines <br /> First 100 feet or fraction thereof <br /> For additional 100 feet <br /> <br />C. LAWN SPRINKLER SYSTEM <br /> <br />Bach protective backflow device <br /> <br />D, OTHER (as ret. lo/red by OSP$C and <br /> B~lding Offictal) <br /> <br /> $30.00__ <br />__$15.00~ <br /> <br />$ 4.50-- <br /> <br />5, FEES <br />Al. En~:r total of fees from Sec. # 4 <br />A2. Add 5% smcharge 605 x Al) $ <br /> <br /> Subtotal $ <br />B. Enter 25% of line A1 for Plan Review <br /> (.25 x Al) if required $ <br /> C. Investigation Fee (if required) $ <br /> D. ReiaE~;,9 Fee $ <br /> <br /> et TOTAL AMOUNT DUE $ .'~grTD <br /> <br /> <br />