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Received
<br />Date:
<br />
<br /> Salem, O~N;IOn 97301
<br />
<br /> PhQne 588-5147
<br />Cede-A-Phohe 4:30 p,M. · 8:00 A.M.
<br />
<br />PLUMBING PERMIT APPLICATION
<br />
<br />Job~,ddressg ',/ ' Site No,: Cross Street:
<br />ui de~'s'Re'~stration NO.: - ~/ - '
<br /> ..... ,.,, -, .,, , . ,: · ,.,.. ,
<br />Residential: ~ New: [~ Addition: [] Occupancy Use of Building:
<br />Commerclafi Aiteraflon: [] Relocation: [] Change: []
<br />
<br /> NO. I~EE AMOUNT
<br /> Base Price $20,00
<br /> Residential ,
<br /> hew consfructk)n (each f~xtura) , , '[ ~ $ 9.00 ',!
<br /> ' 9,00
<br /> Alterations (each fixture) :'. ,,
<br /> Re-located Residence (each fixture ' . 4,50
<br /> Commercial , ,.
<br /> ' ' I 9.00
<br /> New Conatructioq,(each fixture)· , · i
<br /> Alterations (each fixture) ' g,o0
<br />
<br /> For the fi~i 100 feet or fraction thereof 20,00
<br /> For additional 100 feet ' 15.00,
<br /> Sewer Service Lines
<br /> First 100 feet Or fraction thereof $0,0~'
<br /> Additional 100 feet 15,co '
<br /> 'Mobile Home Sewer/Water,cennection ' ,: = ;,' · : ,
<br /> ;.... maxmum5~eefength) :, ' :,; .,,.~:. . ,' ":', .. · ". ' ~" ' ~"",25,00 ' :
<br /> Other (as per O~PSC and Building Offi,cial)
<br /> On-Site Technical Review apply at Marion County only)
<br /> Re-Inspection Fee ,, , 25,00
<br />
<br />, : STATE SURCHARGE
<br />"PLAN REVIEW FEE
<br />' INVESTIGATION FEE
<br />Please return COMPLETE APPLICATION : FLEETSURCHARGE $ ·
<br />with the indicated fee. CiTY FEE
<br />
<br />am pedorml~g wor,~ on a property I own or 0eeupy.
<br />lamaregistere~ibullderOR( ,theauthodzedreDresanta, tlveof $1GNATUR OFAPP
<br />
<br />MC 15-45
<br />Rev. 12/87
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