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IFOR. CITY VALIDATIONI <br /> R. cce, ivcd by: <br /> D~te: <br /> <br />i MARION COUNTY <br />BUILDING INSPECTION DIVISION <br />'3150 LANCASTER DR NE - SUITE C <br />SALEM OREGON 97305-1398 <br /> <br /> 24 hr. Inspection Line 373-4427 <br />Office: Phone58~5147 8:00am-4:30pm <br />FAX: 588-7948 <br /> <br />'~MBING PERMIT APPLICATION <br /> Please complete all Sections, I through 5 <br /> <br />1. LOCATION OF [NSTALLATXON <br /> <br />pI~vlITS ARE NON-TRANSFER3 RI~ AND EXPIRE IF WORK IS NOT <br />STARTED ~rlTHIN 180 DAYS OF ISSUANCF- OR IF <br /> WORK IS SUSPElqDED FOR 180 DAYS. <br /> <br /> CONTRACTOR INSTALL&TION ONLY <br /> <br />Joule's Plumb~ No. <br /> <br /> FOR OW~R <br /> <br />Property Owner (p/ease pd~t) <br /> <br />A~nt's <br /> <br />3. PL~W SECTION <br /> <br />Ma~on Coun~ do~ not ~uire a pl~ review. <br />We w~l provide pl~ ~view s~ice if you complete <br />S~fion 5B and submit ~o (2) se~ of plans and <br />specifications wi~ ~is applimfion. <br /> <br />PERMIT NO: <br />Date: <br />Issued by: <br /> <br />4. FEE SCHED[~E (Complete and enter total in Al betow) <br /> <br /> RJESIDHNTIAL ~ COMMHRCIAL C] <br /> USE OF STRUCTUPJk <br /> NEW [3 ALTER. AT[ON [3 ADDITION D RELOCATION <br /> <br /> No. X Fee = Sum <br />BASE FEE <br /> <br />RESIDENTIAL (each fixture) <br /> Aurora Dwelling Plumbing Fe~ __.sq. ft. x $.070 <br /> <br />Single Family or multi-family per <br />dwelling unit <br />N~v construction $10.00 <br />Alterations $10.00 <br />Reconnect ! $ 5.00 <br />l~localed Structar~ $ 5.00 <br />Modular SLructurc $ 5.00 <br /> <br />Water Linen <br />First 100 fi. or fraction thereof $20.00 -- <br />For ea. addni' lO0 tL (up to <br />maximum of 500 ft.) $15.00 -- <br /> <br /> maximumof500 fi.) $15.00 -- <br /> <br />Water Lincs <br />Fkst l(X) IL~or fraction thereof $25.00 -- <br />For ea. addnl' I00 <br /> $15.00 -- <br /> <br />PROTECTIVE BACKFLOW DEVICE <br /> Lawn vacuum breaker (sprinkler system) <br /> All oth~ <br /> <br />$4.50 <br />$10.00 -- <br /> <br />OTHER (~s required by OSP~C <br /> and Buil&'~g Ol~cial) <br /> <br />DWELLING PERMrY LABEL # of Labels <br /> <br />5. FEES <br /> <br />Subtotal <br /> <br />B. Enter 25% of line A1 for Plan Review <br /> (Al + .25), if requited <br />C. Investigation Foe (if required) <br />D. Reinapection Fee ($'25.00) <br /> <br /> TOTAL AMOUNT DUE <br />Rcc~pt No. <br /> <br /> <br />