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Apt~ce~iO~ Received,
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<br />'Application,Approved
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<br />D.e,' /0
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<br />~7301
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<br />MBi'NG' PESM I."[
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<br />NOTE: APplicants must hold O~egon: :Registration to oonduct a plumbing' .b.',Slqes~ [] or. must be ,property owner/operator, not
<br /> h'iring oUtside help [~, :lndi~a~te.'~tatus. ' '
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<br /> ISUS NESS
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<br />Job Address
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<br />Owner. _ Address . Phone , . .
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<br /> ' : , :' ' . ,: ' .", TYPE OF PERMIT' ' ' : .,, ' ..' ', . "' NO, 0F ri'EMS: ,"'FEE ON'EACH .~'OTAL~AI~IOUNT
<br />Base Price ' .'. :'" · ,:-,,: :: · , ..' ' - · $ 5.00
<br />Ro~i~ rial "'.:: ': ' i .... ' ~-:. ' · , ,
<br />', - ' $4.00,
<br />Kitchen Uni~ ncludes Wate~ Heater * · ". . , . ~ ... , .
<br />Bath Unlt {~u )' ',,' , , ...... . "
<br />-': Bath Unit:half)' : ", , ". · : : ' .': ' : !.,, ' : , ' :': : '$3,00 ' I
<br />. I;aundrv U~it . ;., ' ~' · .', . $3,00 ,, "
<br />M sceiianeous F~xtures · , .. , · ' ' "' ' ' · $200 :
<br />~-,O_mmercial: ,:' .,.:, '.,' ', ,:, ".i ',. :: :., ..;i :. ,..,,' , ,.'., i ..,: .. . · .
<br />1 to 50.F xtures '
<br />Over 50 Fixture~ ..... ' ' - :." , ·., , '$1,00 ea
<br />Alteratmns &
<br />.,Lawn Sp ink ng Sy tern .
<br /> TO and rncludin~ each protective device ..... : ' .., : ' ' : ':,, ' ' . $2,00 ·
<br />"::.. ' . : ' , ",:.-:, ,; ? ;'' ,,L" ,']: .. . '"iToTALAMouNT. ALL"TEMs · " ~ '
<br /> '" ' i: . : ::.' , ' ' ' :' :: "SURCHARGE ' ' '; :' "
<br /> . '.. , , - , ~,.' .' · ,. '.,'
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<br /> that'all ;plumb, rig. work will be done in aee~rdanee.with a, ppli~able provisions o~ Oregon ReVised S~atutes ,Chapters' 447.
<br />and I and applicable' cqdes,-ahd that rio 'h~ip, will I~e~pl~/e;d unless ,li~;~nsed, u~ter ORS 693.
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<br />,Return, :Complete Application' with' the Indicated Fee.
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