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Received
<br />
<br />MARION COUNTY Bt~tLDING INSPECTION
<br />/ Send, or Bldg, No. 225
<br /> 220 High Street NE
<br />
<br /> PLUMBING PERMIT APPLICATION
<br />
<br /> JU~ 1 0 ~991
<br />MARION COUNTY
<br />BUiLDiNG INSPECTION
<br />
<br />Ownel~: ~ho · " Mai g6dd ss:
<br />Job~,ddrees: Site No,: Croes Street: ,
<br />
<br />Plumbing Installer: Phone: Address: ' '
<br />
<br />Horce Builder's Registration No.: ~ ' '
<br />......, :',. ., . ..... "? :-'::',,'-'
<br />Residentia [] New: '[] Addition: [] , Occupancy Use o~ Building:
<br />Comrcereial: [] Alterationi [~ Relocation: [] , Cl~ange: ~ I
<br />
<br /> Base Price NO. FEE AMOUNT
<br /> $~o.qo
<br /> Resident a . ,
<br /> New construction each fixture ,, $ 9.0(~
<br /> Alterations (eesh fixture) .,, I~ 9,00 ,"~ ,~-,., .
<br /> Re-I~eted Residence.(eesh f xture) , 4,50
<br /> Commercial
<br /> NewConstructon(eeshfxtum) ,, '" , 9,00' I
<br /> Alterations (each f xtum) , i 9.00
<br /> Water L ne~
<br /> For the first 10~ feet or fraction thereof" . 20.00
<br /> For additiona 100 feet ., 15,00
<br /> Sewer Service Lines
<br /> First 100 feet or fraction thereof': ' 30,00
<br /> Additional00feet . ' ., ' , . 15,00:
<br /> Mobile Horce sewer~vater cennectioe · i ,' ',, '" , ' ~, , ' ' ' ; ~ ' ' :
<br /> (rcaxircurc 5 feet length) 25.00
<br /> Other (es per..O$ PSC and Building O. fficial) .....
<br />On-Site Teshn ca Rev ew app y at Marion County only) '
<br />Reqnspaction Fee , . 35,00
<br />STATE SURCHARGE
<br />REVIEW FEE
<br />PLAN $ . , ,
<br />INVESTIGATION FEE $
<br />Please return COMPLETE APPLICATION, FLEET SURCHARGE $
<br />with the indicated fee. CITY FEE $
<br />: TOTAL $
<br />
<br />( ) ] am a registered builder OR ( i the authorized representative of SIGNATURE OF APPLICANT'
<br /> a registered builder.
<br />[ 'J-~ Tdeworkwlllbe3erfotmedbyereglsremdbuilde~
<br />~I Othe~
<br />, agree to install ~co~ ngo be subm ~o pans afl~ specif~tions, the lew~ of the msm of Oregon and the o~ nan,s of MaCon Coup.
<br />
<br />MC 15-45
<br />Rev. 12/87
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