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FOR CITY VALIDATION[ <br /> <br />COMMUNITY DEVELOPMENT CENTER <br />285 Church S~ NE · Room 132 <br /> Salem, OR cfl~01 <br /> <br /> 24 hr. Inspection Line 3734427 <br />Office: Phone 588-5147 8:00am - 4:30pm <br />FAX: 588-7948 <br /> <br />IPLUMBING PERMIT APPLICATION <br />Please complete all Sections, I through <br /> <br />L LOCATION OF INSTALLATION <br /> <br />pEIOitTS ARE NON-TP. ANSFERABLE AND EXI~IRE IF WORK IS NOT <br />STARTF. D WITHIN 180 DAYS OF ISSUANCE OR IF <br /> WORK IS SUSPENDED FOR 180 DAYS. <br /> <br /> CONTRACTOR INSTALLATION ONLY <br />Cmmactor I Phone <br /> <br />Mailing Addr~s <br /> <br />Plumbing Board: <br />C. entrae~or's l~ard Rog. No. { lob No. <br />Ioumeymnn's Plumbers No. <br />Conh'actor's Si~mturz: <br /> <br />liB. FOR OWNBR INSTALLATIONS <br /> <br />Agent's Si{uattu~: ~f <br /> <br /> MARION COUNTY <br />Issued by'~[lll nm., . <br /> .... '~ ~$PECTION <br /> <br />4. FEB SCHHDULB (Cumpl~o and enter total in Al below) <br /> <br /> RILqlDENTIAL r~ COMMERCIAL El <br /> USE OF ~rKUCTURB: <br /> NEW ~ ALTERATION [~ ADDITION O RELQCATION I~ <br /> <br />BASE FEE $20.00 <br /> <br />RIiSID~NTIAL (each fixture) <br /> Aurora Dwelling Plumbing Fee --~1- fi, x $.070 = <br /> <br />Single Family or multi-family per <br />dwelling unit <br />New cemm~ctlou $10,00 <br />AR~atlom $10.00 <br />Rec. o~dlec [ $ 5.00 <br />R¢lova~l Stmetu~ $ 5.00 <br />Modular sm~cmm $ 5.00 <br /> <br />Water Lines <br />First 100 fi, or fraction ~ltemof $20.00 <br />For ~. addul' 100 ti. (up ~o <br />maximum orS00 ft.) $15.00 <br /> <br />SsintaO' & Sloan Lines <br />F'wzt 100 f. or fraction Ihereof $30.00 <br />For addul' 100 ft. (up to <br />maximum of 500 ti.) $15.00 <br /> <br />COMMERCIAL (~aeh <br /> <br /> New construction $10.00 <br /> Altemtiom $10.00 <br /> R~onnect $10.00 <br /> <br /> First 100 ft. or frnction lhemot' $25.00 <br /> For ea. addul' 100 ti. <br /> <br />$15,00 <br /> <br />Sanitary & Storm Lin~ <br /> First 100ti. or tiac/ion thereof <br /> For addnl' 100 ft. <br /> <br />$30.00 <br /> <br />$15.00 <br /> <br />PROTECTIVE BACK, PLOW DEVICE <br />Lawn vacuum bi~aker (sprinkler system) $ 4.50 <br />AIl others $10.00 <br /> <br />OTHER (zs teqoimd by OSPSC <br /> and l~ildi~g Ofl~cinO <br /> <br />D'~J~,INO PERM IT LABEL # of Labels i~/C <br /> <br />3. PLANP.~VIBW SBCTION <br /> <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 />specifications with this application. <br /> <br />MC 15-45 <br />Rev. 1/96 <br /> <br /> <br />