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FOR CITY VALIDATIONI <br />Received by:, <br />Dato: <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> COMMUNITY DEVELOPMENT CENTER <br /> 285 Church St NE · Room 132 <br /> Salem, OR 97301 <br /> <br />24 Hr Inspection Lin~ 588-7904 <br />OWw,~ 588-5147 8:00aan.-4:30p.m. <br />FAX: 588-7948 <br /> <br />PLUMBING PERMIT APPLICATION <br />Please complete all Sections, I through <br /> <br />1. LOCATION OF INSTALLATION <br />l~peay Owner / Phone <br /> <br />PERMITS ARE NON-TRANSFERABLE AHD EXPIRE IF WORK IS NOT <br />STARTED WITHIN 180 DAYS OF ISSUANCE OR IF <br /> WORK IS SUSPENDED FOR 180 DAYS, <br /> <br />2A. CONTRACTOR INSTALLATION ONLY <br /> <br />2B. FOR OWNER INSTALLATIONS <br /> <br />Property Owner (please prir~) <br />Mailing Address I P~one <br />City/State,/Zip <br /> <br />3. PLANREVIEW 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 />PERMIT NO: <br /> <br />Date: <br /> <br />Issued by: <br /> <br />4. FEE SCHEDULE (Completa and entor total ia A1:~low) <br /> RBSIDENTIAL ~ COM1VI~IAL U <br /> USE OF STRUCTURE: / <br /> NEW ~] ALTERATION ~,~DDITION ~1 RELOCATION <br /> <br /> No. X Fee = Sum <br />BASE FEE $20.00 <br /> <br />RESIDEH'rlAL (each fixture) <br /> Aurora Dwelling Plumbing Fee --. sq. 1~ x $.065 <br /> <br />Single Family or multi-family per <br />dwelling unit <br />New construction $10,OO <br />Alterations ~ $10.OO <br />Reconnect $ 5.OO <br />Relocated StlUctore $ 5.00 <br />Modular Structure $ 5.00 <br /> <br /> Water Lines <br /> First IOO fl. or fraction thereof $20.00 __ <br /> For ea. addnl' 100 ft. (up to <br /> maximum of 500 fl.) $15.00 -- <br /> <br />Sanitary & Storm Lines <br />First 100 fl. or fraction thereof $30.00 -- <br />',~or addnl' 100 fl. (up to <br />-- ' maximum of 500 ft,) $15.00 -- <br /> <br /> COMMERCIAL (each fixture) <br /> <br /> N~v construction $10.OO -- <br /> Alterations $10.OO -- <br /> Reconnect $10.OO -- <br /> <br />Wa~er Lines <br /> First IOO ft. or fraction thereof <br /> For ca, addnl' 100 fi. <br /> <br />$25.OO -- <br />$15.OO -- <br /> <br />Sanitary & Storm Lines <br /> First IOO ft, or fractinn thereof <br /> For addni' 100 fl. <br /> <br />$30,OO -- <br />$15.OO __ <br /> <br />PROTECTIVE BACKFLOW DEVICE <br />Lawn vacuufll breaker (sprinkler ayah:m) $ 4.50 -- <br />All others $10.OO -- <br /> <br />OTHER (as required by OSPSC <br /> and Building Official) <br /> <br />DWELLING PERMIT LABEL # of Labels N/C <br /> <br />MU 1545 <br /> <br />5. FEES <br /> A 1. Enter total of f~ from S~. #4 <br /> A2. Add 5% sur~imrg~ (.05 x Al) <br /> Subtotal <br /> <br /> B. Enter 25% of line A l for Plan Review <br /> (Al + .25), if required <br /> C. Investigation Fee (if required) <br /> D. Reimpeetion Fee ($25.00) <br /> <br /> TOTAL AMOUKr DUE <br /> Receipt No. <br /> <br /> <br />