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FGb-07-96 03:08P CITY OF AURORA 503-678-2758 P.01 <br /> <br />) Date:~' { ~ Hr In,p~d~ Lin,:. ss~-?9~ MANIUN O0UNTY <br /> <br />PLUMBING PERMIT APPLICATION <br />Please complete all ~ections, I through <br />1. LOCATION OF INSTALLATION ~0 ~/ <br /> <br />P~M~S AR.~ NON-I'RANSI~R.ABI.~ AND F~PIRE IF WO~ <br /> STAR~ ~IN 1~ DAYS OF ISSUAN~ OR IF <br /> WORK I$ $USP~DED FOR i~ DAYS. <br /> <br />2A, CON'rRACTOR INETALLATION ONLY <br /> <br />_l~..i{it~ Addrmm ................. ~_,, , <br />Plumbing Board: <br />Conltaclor's Board ReM. No. <br />$o,,meyman'm Plumb~'~ No, <br /> <br />Cmllraclor'm Si~n,,tu~e: <br /> <br />-=~ Job No. ..._, __ <br /> <br />211. FOR OWN'BR INSTALLATIONS <br /> <br />~y O~ncr gple~,print) <br />MailinR Adder~ { Phon~ <br /> <br />City, Slme./Z¥ <br /> <br />4. FBB 8CHltDI,q-3i (complm and ont0r Iou,! in Al below) <br /> <br /> lt~IOBNTXAL C{ COMMH]~CIAL ~ <br />USB OF STRUCTURB: <br />N£W ~ ~LT£RATION ~ ADDITION ~ Rm-OCATION ~ <br /> <br /> No. X Pm -, aura <br />BA$~ FEB $2G00 <br /> <br />Water [..irl~l <br />F'~t ~00 it. or f~actioa Ihcroo£ $20.00 <br />R~r ~a, m,J~tl' 100 it, Cut, itt <br />,n~imum orS00 it.) ~ $15.00 <br /> <br />Safli~tw & Slon'n <br />l~i~t 100 iL or fraction ~et~f $30.00 <br />For addnl' I00 fi. (up !o <br />maximum orS00 ft.) $15.00 <br /> <br />COMMI~RCIAI, (~l,;h fixture) <br /> <br />New eonslm~tiun <br />Altorelior~ ~ $10.00 <br />Reaonn~¢~ ~ $ lO.O0 <br /> <br />Water Li,ia~ <br /> F/rat 100 t'L o~ fraction <br /> For em, nddnl' 100 ft. <br /> <br />S25.00 <br /> <br />S15.0o <br /> <br />Sanitary & Slonn Lines <br /> Firsl 100 l~, or fraction <br /> For addni' 100 fl, <br /> <br />SIS,00 <br /> <br />PRO'IBC'fIVE BACK. FLOW DilVlCB <br /> Lawn vacuum Ix~k~r (,ia'inkier system). <br /> All ol,hem <br /> <br />S4.50 ~ <br />$10.00 <br /> <br /> ${{CTIOI~-~_~ _~~ <br /> Marion County does not require a plan review. <br /> We will provide plan review service if you complete <br /> Section 5B and submit two (2) sets of plans and <br />~9~d~/~specificati°n~ wjJ~ this applicatio~.~l~lg~o~. ' <br /> <br />a~ of Lal~lm '-"'- <br /> <br />B, R,,l~r 2~% of line Al fur Piton ~vi~ <br /> <br />C. Invostigst~n Fee (if~quir~) ~....,~_ $ <br />D, Reimpcctiofl Fcc (S25,~) <br /> <br />R{¢~ipt No. <br /> <br /> <br />