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/ <br /> -''I.~_.~U''~' . MARION C{)UNTY' BUILDING INSPECTION <br />Received <br /> · . Senator Bide,, e, 228 <br /> ~ 220~a Str~'~ NE <br /> <br /> 9S7 <br /> <br /> ~AR~ON COUN~MBING PERMIT APPLICATION <br /> BUiLDiNG tNSPEC~t <br /> <br />Owner: Phone; Address; <br />Situ~ Address: ~ . , Site No,: Cross Street: <br /> <br />Plumbing installer: Phone: Address: <br />Home Builder~ Regi~ration No.; <br /> <br />Residential: ~ New: ~ Addition: ~ Occupancy"'T' Use of Building; <br />Comme~lah ~. Alteration: ~ Rel~atio~: ~ Change: ~.J .... <br /> <br /> NO, FEE AMOUNT <br /> Base Pdce $10.00 <br /> Residential <br /> New construc!!? (each fixture) //" $ 7,50 <br /> Alterations (each f xram) ..... 7.50 <br /> Re-located Residence (each fix'tam) 3,76 <br /> Commercial : ' ...... , <br /> New Construction (each fixture) 7,50 <br /> Alterations (each fixture) 7.50 <br /> Water Lines <br /> For the first 100 feet or fraction thereof 20,00 <br /> For additional 100 feet 15.00 <br /> Sewer Service Lines <br /> First 100 feet or traction thereof 30.00 <br /> Additional 100 feet ' 15,00 <br /> Lawn Spdnlding System ,, <br /> TO and including each protective device "~',00 <br /> Other (es per OSPSC and Suildir),~ Official) <br /> On-Site Technical Review (apply at Marion County on.l~), <br /> Re-lnspectJo.n. ,~ee ...... <br /> STATE SURCHARGE- _ <br /> PLAN REVIEW FEE $ <br /> DOUBLE FEE $ <br />Please return COMPLETE APPLICATION FLEET SURCHARGE $ <br />with the indicated fee. CITY FEE $ <br />TOTAL $ <br /> <br />) am a ,eglstered builder OR ( the authorized representative of SIGNAl.URE OF APPLICANI' <br /> <br />] The work wlfl be performed by a registered builder. <br /> Other <br /> <br />) ~agreetolnstallaccordingtothesubmitteo r)l~nsanospe~ifi~ations, thelawsofthestateofOmgonandtheol~lnancesofMarlonCounby, <br /> <br />MC 15-45 <br />Rev, 3/87 <br /> <br /> <br />