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.~pplieation Received <br /> <br />Date ............................................ <br /> <br />Appllcation Approved .............. <br /> <br /> Marion County~ Oregon <br /> BUILDIN(i DEPARTMENT <br /> <br /> APPLICATION FOR PERMIT <br /> <br />PLUMBING INSTALLATION <br /> <br /> Blanks above this line not to be filled by applicant [ Fee £or Psrmit _ -~--..~'~.. ............. <br /> ........ <br /> Appliexmt m~t fill ~ ~om h~do~ ~ I~ Or Indelible Pe~ <br /> l Alter~ ~ <br />~ppl~ca~ion is hereby made to ~ Repair ~Plumbf~g Pipes or F~tures ~co~ing ~ plans and ~pecific~t~on$ and d~scmptions as g~ve~ <br />below: ~ Install ~ ~ ~ ~ ~ <br />Loc,~ion of bufldin~Number and S~eet .~~,..J.,__-~.......(...../..._~..~.....~_.__~.~.~..~. ..... <br />......... , .................... ............. ............ ,..._ .................... ................................................................................... <br />Owne~a~e and Address of Owner ...... ~2..~..~.._~.~ ........................................................................................ <br />Name ~d Address of Plumber ............................. ~ ..................... ; .......... ~. .................................................................................................... <br />Class of building .................................................................................... Height in Stories ........................ Occupied ~s ................................ <br /> <br />Water Closets <br />Bath (tub) <br />Basins <br /> <br />I~tn Drains <br />Sinks <br /> <br />Laundry Trays <br />Garbage Disposal <br /> <br /> DesCHl~on of NumBer 0[ Fixtures <br /> <br />Drinking Fonn~i~ No .................... i ........... <br /> <br />Shower Baths "._.....,~_, ................... <br />Wash Racks ............................... <br />Drains, Stable <br /> <br />Slop Sinks <br /> <br />Boiler Blow 0~ <br /> <br />Dishwasher <br /> <br />Re~lqgerator Wastes" .................................. <br />Automatic Washers" ................ ~_ ............... <br /> <br />Other Fixtures nos specified abow ................................................................................................................................................................... <br /> <br />On back of sheet give diagram showing sizes and location o:[ £ix~ures, w~iste~, vents, soil pipes, drains, sewers, and all cleanout~, <br /> <br /> l Alter <br />I agree tot Repair ~ the plumbing system according to ~is desc~ptlon, plans and specificatlol~ and the Plumbing Code of she State <br /> ~, Install <br /> <br /> ' . ........: .......... Z ...................... ...._,,._,_....~ ......................................... <br /> <br /> <br />