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FOR CITY VALIDATION[ <br />Reoe[ved by:. ~ <br />Dato: [ <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> COMMUNITY DEVELOPMENT CENTER <br /> 285 Church St NE · Room 132 P~=RMIT NO: <br /> Salem, OR 97301 <br /> Date: <br /> <br /> 24 hr. Inspection Line 373-4427 <br /> Office: Phone S$8-$147 8:00am - 4:3gpm [~U~[ by: <br /> <br />PLUMBING PERMff A~LICATION ~ (co~,te ~d ~,~ ~i~ A~ b~o)) <br />Pl~ecomplete~l~tions, IthroughS~ ~[- ~ ~~I~ ~ cp~c~ Q <br /> <br /> I uss oF ~uc~: ~'~ ~ <br /> <br />1. LOCATION OF INSTALLATION <br /> <br />PERMITS AR~ NON-TRA~SFE. RABLE AND EXPIRE IF WORK IS NOT <br />STARTED WITHIN 180 DAYS OFISSUANCE OR IF <br /> WORK [$ SUSPFNDED FOR 180 DAYS. <br /> <br />~ CONTRACTOR INSTALLATION ONLY <br /> <br />Plumbing Boa~ <br /> <br />2B. FOR OWNKR INSTALLATIONS <br />l~pe~y Owner (pl~ priat) <br /> <br />City/State/Zip <br /> <br />Ag~lt'~ Signature: ~ <br /> <br />!~SPECTIOBi N~. x v~ = s~ <br />BASE FEE ~?.o.0o <br /> <br />RESIDENTIAL (each fixture) <br /> Aurora Dwelling Plumbing Fee <br /> <br />Single Family or multi-family per <br />dwelling unit <br /> <br /> Alterations <br /> <br /> F~r~t 100 ft. or fraction thereof <br /> For ea. addni' 100 ft. (up to <br /> maximum of S00 ft.} <br /> <br /> Fimt 100 fL or fraction ~hereof <br /> For nddnl' 100 ft. (up to <br /> maximum orS00 ft.} <br /> <br />COMMERCIAL (each fixture) <br /> <br />sq. ft. x $.070 = <br /> <br />10.00 <br />$10.00 <br />~.00 <br />5.00 <br />5.00 <br /> <br />$20.00 <br /> <br />$15.00 <br /> <br />$15.00 <br /> <br />$10.00 <br />$10.00 <br /> <br />$15.00 <br /> <br />Sanite~ & Storm Lioea <br /> Fimt 100 fL or fi'action ther~f <br /> For sddnl' 100 fL <br /> <br />$30.00 <br /> <br />$15.00 <br /> <br />PROTECTIVE BACKFLOW DEVICE <br />Laws vacuum breaker (spri~der system) $ 4.50 <br />All othem $10.00 <br /> <br />OTHER (as roquit~d by OSP~C <br /> and Bulling Ol~ci#l) <br /> <br />DWELLING PERMIT LABEL <br /> <br />#of Labels N/C <br /> <br />3. PLANREVIEW SECTION <br /> <br />Marion County does not require a plan review. <br />We will pwvide 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, FEES <br />Al. Enter total of fees lmm Sec. ~4 $._ ,0~ <br />A~ Add5%surchafge(.OSxAl) $ '~,0~ <br /> Sobt~al $ <br /> <br /> B. ~ter 25~ oflino A1 forP~ Renew ~f <br /> (Al + .~), if ~qui~ $ <br /> C. lnv=atigat~n ~e (if~qui~) _~ .__ ~ . $ <br /> D. ~ . ~ ~ s~ <br /> <br /> R~¥t ~.~ <br /> <br /> <br />