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FOR OFFICE USE ONLY <br />Received !~ <br />Date: <br /> <br /> PLUMBING PERMIT~FPLICA~ION "~"] <br /> please ~omplete ali Se~ions, I through <br /> <br /> I. LOCATION OF INSTALLATION <br />~obAdd. ss 250 M@v~ ~.Y~ <br /> <br />_~' Detroit i cm~s~ Lake ...... <br /> vimcao~s Toke Highway ?? Ea~,Tnvn L~i O~ Meyer <br /> <br />~t.= pz~z L~ke on the Right, it's the first <br />driveway on the vioht. . <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> <br /> Salcra ,~egon 97~,~ ~ .' <br /> <br /> Phone 588-5147 $:00 a.m. - 4:30 p.m. S~E ·: Pfi~R NO. .......... <br /> Codo-~on,: 588.~4 <br /> <br />PERMITS ARE NON.TRANSFERABLE AND NON.REFUND~LE AND <br />EXPIRE IF WORK IS NOT STARTED WHHIN 180 DAYS OF ISSUANCE <br />OR IF,WORK IS SUSPENDED FOR 180 DAYS. <br /> <br />!~rop~ow.er ALVIN & BARBARA SANTOS <br />~m,~*dd~,,54-127 KEALALANI PL. ~gA"'29.3'9999 <br /> <br />ci~sm,aip HAUULA, OAHU , HI 96717 <br /> <br />The.instal~pn_is l~ing ~e on property I ownwhich is npt inXended for ~ale, <br />Jem.~, or r~nt. <br /> <br />Owner's Signature <br /> <br /> 3. PLAN REVIEW SECTION <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 optiona~ plan review program does not suspend the <br /> required submission ofplans, and specifications when required <br /> by the Oregon Structural Specialty Code, Chapter 53. <br />'MC 1§.45 '% <br />Rev. 7/92 <br /> <br /> NO. X FEE - SUM <br /> <br />BASE FEE $20.00 <br />A, RESIDENTIAL <br /> <br /> Single Family or multi-Far3ti. 'ly per <br /> dwe'll'_mg unit (each fixture) <br /> New construction $ 9,00 <br /> Alterations $ 9.00 <br /> .lq~ '~- Re4o~ated structure _ _ $ 4,50 <br />~ water Lines <br /> First 100 ft. or fraction thereof I $20.00- <br /> For additiofial 100 it. (up to <br /> maximum of 500 feet) $15.00 <br /> <br /> Sewer Lin~s <br /> First 100 feet or fraction thereof - .-.$30.00 . <br /> For additional 100 feet (up to <br /> maximum 500 feet) ~ $15.00 .... <br /> <br />B. COiVI/vlERCIAL (each fixture) <br /> New constmeti6n ~$ 9.00 <br /> Alterations $ 9.00 <br /> Re4ocated 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 ~$30.00 <br /> For additional I00 feet <br /> <br /> C. LAWN SPRINKLER. SYSTEM <br /> Each protective backflow device ~ $ 4.50 ,, · <br /> <br /> D._OTHER (~as~reql.u~r. ed by OS?SC and <br /> l~uilding umc~al) ..... <br /> <br />5. FEES Al. Enter total of fees from Sec, # 4 <br /> A2. Add 5% surcharge 605 x Al) <br /> <br /> Subtotal <br />B. Enter 25% of line Al for Plan Review <br /> _ 625 xAI) ~req.u!red <br /> C. ~v. estisation r_eeO~required) <br /> D. Reimpe~tion l~'ee <br /> <br /> TOTAL AIVIOUNT DUE <br /> <br />Receipt No. <br /> <br /> <br />