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Application Received . _ <br />Date <br /> <br />DEPT."OF BUILDIN( <br /> COUR~ HOUSE?SALEM. OREGON <br /> 588-5147 <br /> <br />Permit Fee , . .... <br /> <br />NOTE; Applicants must hold ~)~e§on Registration. t~ conduct a plu'mbin§ 'business 'r:~ br must be property owner/operator not <br /> hiring outside help I--~. Indicate' status. ' ' ' <br /> <br /> PLUMBING <br /> BUS NESS <br /> LICENSE NO. <br /> <br />JobAddress ~'q~' <br /> <br />HOME'SUILDERS <br />REG'ISTF~RAT, oN NO <br /> <br />Plbg, Installer <br /> <br /> .... < TEMS 'FEE 'ON' EACH TOTAL AMouNT <br /> TYPE OF PERMIT ,' N~) 'OF' <br />I~se Pr=ice <br />Residential . <br />Kitchen Unit , ..... , ''' , · ".: <br />. , .. '. , <br />Charged at Commerc <br />To and including each protective ~evibe ...... · ' <br />..... GRAND T~AE <br /> <br />I certify that all plumbing work will be done in accordance with ":' <br />and 693 and applicable codes, and that no help v ORS,693. <br /> <br />R,e~u, *'h Ci~mplere' APplica.'~tid0 With the..Indicated Fee.'": · ,,' <br /> <br /> <br />