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IFOR CITY VALIDATION[ <br /> Received by: <br /> Date: <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> <br /> ~RMff NO: <br /> <br />PLUMBING PERMIT APPLICATION BrJILDING <br />Please complete all Sections, I through 5 <br /> <br />1. LOCATION OF INSTALLATION <br /> <br />Date: <br /> <br /> PERM!erS ARE NON-TRANgFERABLE AND EXPIRE IF WORK IS NOT <br /> STARTED WITHIN 180 DAYS OF ISSUANCE OR IF <br /> WORK IS SUSPENDED FOR 180 DAYS. <br /> <br />ZA. CONTRACTOR INSTALLATION ONLY <br /> <br />2B. FOR OWNER INSTALLATIONS <br /> <br />Property Owr~r Ipl~tts~prim) <br /> <br />Mailing Address [ Phone <br /> <br />City/State/Zip <br />Owner's Signature: <br />Agent's Signature: <br /> <br />3. PLANRBVIBW//FACTION <br /> <br />Madon 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 /> No, X F~o = Sum <br />BASE FEE <br /> <br /> RESIDBHTIAL (each fixture) <br /> Aueora Dwelling Plumbing Fee sq. ft. x $.065 = <br /> <br /> Single Family or m~lti-family per <br /> dwelling trait <br /> New construction $10.00 <br /> Alterations $10.00 <br /> Recormect $ <br /> Relocated Structure $ 5.00 <br /> Modular Structure $ 5.00 <br /> <br /> Water Lin~a <br /> First 100 ft. or fraction Ihereof $20.00 -- <br /> For ea. addnl' 100 ft. (up lo <br /> maximum of 500 ft.) $15.00 __ <br /> <br /> First 100 ft. or fraction thereof $30.00 <br /> For addnl' 100 fL (up to <br /> maximum of 500 fl.) $15.00 __ <br /> <br />COMMERCIAL (each fmlure) <br /> <br /> Alterations $10.00 <br /> Reconnect $10.00 <br /> <br /> First 100 ft. or fraction thereof $25.00 -- <br /> For ea. addnl' 100 ft. (up to <br /> maximum of 500 ft.) $15.00 <br /> <br /> Fire! 100 ft. or fraction thereof $30.00 <br /> For adchtl' 100 ft. (up to <br /> maximum of S00 fl.) $15.00 <br /> <br />OTHER (as requiredby OSP~C <br />aad Buil~g Ol~cial) <br />DWELLING PERIdlT LABEL # of Lab~la N/C <br /> <br />5. FEES <br /> ^l. E.ter to.lot <br /> A~. Add 5% s~ha~ (,0~ x Al) <br /> <br /> B. ~r 25% of ime Al for Plan ~view <br /> (A I + .25), if ~u~d $.~ <br /> C. ~v~figefion Fee (if ~qu~d) $.~ <br /> D. Reimpeetion ~e ($25.~) $.~ <br /> <br /> Receipt No. <br /> <br /> <br />