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P umbing Permit Applioation <br /> <br /> MARION .COU N TY~?~:':',"%-,, - <br /> DEPT. OFBUILDING INSPECTION <br /> Senator Building # 225 <br /> 220 High St. N,E. 2nd Floor <br /> Sa, lan1; Oregon 97301 <br /> R.H. WlTHROW, BLDG. ADMINISTRATOR <br /> 588-5147 -- 588-5148 <br />5:00 P,M.- ............ CODE-A-Phone 588-5373 ............. 8:00 A,M. <br /> <br />- ' Plumbing Permit Application <br /> <br /> Bldg. Permit No.~ <br /> ? <br /> <br /> Plbg. Perr. t No. <br /> <br /> Date: <br /> <br />Type of Permit: , Tax Lot No: <br /> <br />Owner: ~ <br /> <br />Bldr. & No,:. <br /> <br />, Rue <br /> <br />Rhone: Add[ess:.,. <br />Phons: Address: , , , <br /> <br /> oF ' N(~ ITIEMa FEE ON EACH TOTAL AMOUNT <br /> - TYPE PERMIT <br /> $10.00 <br />Base Price <br />Residential <br /> Kitchen' Unit Includes Water Heater ,,. $15~9C, <br /> Beth Unit (fuil~' 10.00 <br /> Bath Unit (half) ' 5:00 , <br /> Laundry Unit' · ,. 5.00 <br /> <br /> ' M sca eneoes Fixtures "' . '5,00 .... <br />Sewer Service. Line ' ' ' "' ' 10 00' <br />Pr vets - She I be charged per 100 or fraction thereof ' <br /> <br /> es ' 5.00 ea. <br /> 1 to 50 Fixtur .... ', . <br /> Over 50 Fixtures , 3.00 ea.= , .... <br />Alterations & Additions , <br />Charged st Commercial Rates · - <br />Lawn Sprinkling System '"· ' <br />.... " 5.00 <br />To and 10eluding each protective device ' . ,-. ' <br />Please return complete application .SURCHARGE, <br />with the indicated fee. ' <br /> <br />I a~ tee to perform work according 'to the,submittedplans and specifications, the laws of the State of Oregon and <br />the Ordinsnces of Mar on County 'Perm rexp [es if Work not.commenced within 120 days. I further expressly war- <br />rant that comp y w th the prov[s OhS of'ORS 701.005 to 701.125 because: . <br /> <br /> am a registered and licensed plum'ber or <br />The authorized representative of a registered and licensed plumbing contractor, <br /> <br />( ) The work will be performed by a registered and licensed plumber <br />( ) I am performing Work On a property I ~wn dr occupy <br />( ) Other (p ease specify) <br /> <br />SIGNATURI <br /> <br /> <br />