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./ <br /> <br /> FOP. CITY VAT XOATION] <br />Roozived by: [ <br />,Dato: [ <br /> <br />MARION COUNTY BUILDING INSPRCTION <br />COMMUNITY DEVELOPMENT CENTER <br />285 Church St NE · Room 132 <br /> Salon, OR 97301 <br /> <br />PLUMBING PERMIT APPLICATION <br />Please complete all 8ootions, I through <br /> <br />1. LOCATION OF INSrALLATION <br /> <br /> 24 hr. Inspection Line 373-4427 <br />Office: Phone 588-5147 8:00am - 4:30pm <br />FAX: 588-7948 <br /> I <br /> <br />~ ARE NON-TRANSI~RABLI/AND EX~IRE IF WORK IS NOT { <br /> STARTED WITHIN 180 DAYS OF ISSUANCE OR IF <br /> WORK IS SUSPENDED FOR i~O DAYS. <br /> <br />2A. CONTRACTOR INSTALLATION ONLY <br /> <br />Iviailing Address <br /> <br />Plumbing Board: <br />Contractor's Board Reg. No. [ lob No. <br />Journeyman's Plumbe~ No. <br /> <br />2B. FOR OWIqI~R INSTALLATIONS <br /> <br />PERMIT NO: <br /> <br />Date: <br /> <br />Issued by: <br /> <br />4. FI~E ~CH"[~UI~ (Compl~teand ent~ tolallnA1 below) <br /> <br /> RIL~ID~ El COMlvlI~CIAL <br /> U$1~ OF ~rRUCTURB: <br /> NEW [~ ALTERATION El ADDITION ~ RH..OCATION <br /> <br />RESIDENTIAL (each fmure) <br /> Aurora Dwelling Phunbing Fee <br /> <br />Single Family or multi-family per <br />dwelling unit <br /> <br /> Aheratlom <br /> <br />No. X <br /> <br /> sq. ii. x $.070 = <br /> <br />$10.00 <br />$10.00 <br />$5.00 -- <br />$ 5.00 <br />$ 5.00 -- <br /> <br /> FOr ea. addal' 100 ft. (up to <br /> maximum of 500 ft.) $15.00 __ <br /> <br />Sanita~ & Storm Linea <br />~trat 100 IL or fraction the, t~f $30.00 <br />For addnl' 100 ft. (up to <br />mnxtraum of 500 IL) <br /> <br />$15.00 <br /> <br />Sanitary & Storm Liaea <br /> Fa~t 100 tL or fraction thereof <br /> For add~l' 100 IL <br /> <br />$~0.00 <br /> <br />$15.00 <br /> <br />PROTECTIV~ BACKFLOW DEVICE <br />Lavm vacuum brcak~ (~-iukler s~m) $ 4.50 <br />All other$ $10.00 <br /> <br />OTHER (ttr~ulredbyO$~$C <br /> tad Buil~ag Ol~ci~l) <br /> <br />DWBLLINO PERMrr LABEL #of Iai}oh <br /> <br />3. PLANREVIBW SECTION <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 />5. FKl~q <br />Al. Eat~ Io~l of f~ flora S¢~. t~4 $ <br />~ Add 5~ .~ (.05 x A l) $ <br /> ~bt~[ $ <br /> <br /> g. ~25~1~cA1 for P~R~ <br /> <br /> D. ~n ~ (~5.~) $ <br /> <br /> ~T~ ~O~ D~ <br /> ~t No, <br /> <br /> <br />