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IFOR CITY VALIDATION <br /> Received by:, <br /> Date:~ <br /> <br />I P/easPLUMBING PERMIT APPLICATION <br /> e complete ail ~ections, I through <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> COMMUNITY DEVELOPMENT CENTER <br /> 285 Church St NE · Room 132 PERMIT NO: <br /> Salem, OR 97301 <br /> <br />24 Hr In~aoetion Line: 588-7904 <br />Offico: 588-5147 8:00aan.-4:3Op.m. <br />FAX: 588-7948 <br /> <br />1. LOCATION OF INSTALLATION <br /> <br />PERMITS ARE NON-TRANSFERABLE AND EXPIRE IF WORK IS NOT <br />STARTED WITHIH 180 DAYS OF ISSUANCE OR IF <br /> WORK IS SUSPENDED FOR 180 DAYS. <br /> <br />2A. CONTRACTOR INSTALLATION ONLY <br /> <br />Pinmbing Board: ~t/~ - 3 ~, P <br /> <br />Contractor's Board Reg. No. ~ J Job No. <br />Journeyman's Plumbers No. <br /> <br />2B. FOR OWNBR INSTALLATIONS <br /> <br />Prope~y Owner (plea~print) <br /> T <br />Mailing Address [ Phone <br /> <br />City/StateJZip <br /> <br />Agent's Signature: <br /> <br />3. PLAN REVIEW SECTION <br /> <br />Marion County does not require a plan review. <br />We will provide plan review service if you complete <br />Section SB and submit two (2) sets of plans and <br />specifications with this application. <br /> <br />Oa~e: <br /> <br />Issued by: <br /> <br />4. FEE SCHEDULE (Complet~ and enter total in A1 below) <br /> <br /> RB$1DENTIAL Cl COMMBRCLAL~ <br /> USE OF STRUCTURE: <br /> NEW ~ ALTERATION r~ ADDITION ~ RELOCATION <br /> <br />BASE FEE $20.00 <br /> <br />RESIDENTIAL (~¢h f'txture) <br /> Aurora Dwelling plumbing Fee -- sq. ft. x $.065 = -- <br /> <br />Single Family or multi-family per <br />dwelling unit <br />New constn~ction $10.00 -- <br />Alterations $10.00 -- <br />Reconnect $ 5,00 -- <br />Relocated Structure $ 5,00 -- <br />ModularStmcture $ 5.00 -- <br /> <br />Water Lings <br /> Ftrst 100 ft. or fraction thereof <br /> For ea. addal' 100 ft, (up to <br /> maximum 0f500 ft.) <br /> <br />Saullary & Storm Lines <br /> First 100 ft. or fraction thereof <br /> For addnl' 100 ft, (up to <br /> maximum of 500 ft.) <br /> <br />COMMERCIAL (each fixture) <br /> <br />$20.00 __ <br />$15,00 -- <br /> <br />$30.00 -- <br />$15.00 -- <br /> <br />$1o.oo O0 <br />$10.00 -- <br />$10.00 -- <br /> <br />Water Lines <br />First 100 ft. or fraction thereof $25.00 -- <br />For ea. addnl' 100 ft. (up to <br />maxanum of 500 ft.) $15.00 <br /> <br /> maximum of 500 ft.) $15.00 -- <br /> <br />OTHER (as requiredbyOSP~C <br /> and BuiMdng O~ciaO <br /> <br />DWELLING PERMIT LABEL g of Labels N/C <br /> <br />5. FEES <br />Al. Emer totalof fees from Sec.//4 $~ <br />A2. Add 5% succharg~ (.05 x Al) Subtotal 1~,~ - <br /> B. Enter 25% of line A1 for Plan Review <br /> (Al + .25). if required $.__ <br /> C, Investigation Fee (if required) $.__ <br /> D. Reinapectinn Fee ($25.00) $.__ <br /> TOTAL AMOUNT DUE $ g/r~ ~ <br /> Receipt No, <br /> <br /> <br />