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ApplicatiOnDa,ce ~' Received~/ ..
<br />Application Approved
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<br />"ale ""'
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<br />NOTE: Applicants'
<br /> hiring outside t
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<br /> PLUMBING ' '
<br /> BUOINESS '
<br /> LICENSE NO.
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<br /> Marion,. Count~
<br /> DI:PT. OF,.BUII:.DING INSPECTION
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<br /> 3180 CENTER STREET N,E,
<br /> gALEM 'OREGON 97301
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<br /> · ~. ',. ~S~st4~,,, , ' ',,
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<br />'APPLICATION FOR PLUMBING'~p'ERMIT'
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<br />Bldg. Permit ~ ./3 -'/~ ~ '~
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<br />PIbg
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<br />Address ~'~' '1 :l~y ~,,~.~, /~¢,~1~:~ Pi~one
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<br /> ross.-. Phone
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<br /> ...... NO OF "' EE ACH.
<br /> . .', . ~ .; ' TYPE OF'PERMIT . . ' ' ' ..... . . iTEMS · . F . 0NE .. TOTAL AMOUNT.
<br /> BasePdce., ..... ...... ",' : ',i~..~'~, ' ~ ·" ' , · "' ,.i ' ', .' ,' .. :',',.,,.,. ' $ 5.00
<br /> Residential' ' · ~ ' ' ' · ',. , · - '· ' ' '."
<br /> Kitchen Unit Includes W~ter"~;ater ' · ,, .' ,,,. ,, :,i' I, . 84.00' , <,'/. ~
<br /> Bath Unit (full).., ., ,.., '..~..' .. , , ' .. · · $5.00 ,
<br /> ,: ' · , · :.' .... ~ , '-8300',
<br /> Bath' Unit (half) ' ' . .....
<br /> LaundryU ~t '. .... ~.i ........ ' ' ...:" ,~ ,., · $3,00' · · ~. ~
<br /> · · ' ' "' .. $2·00 ....
<br /> Miscellaneous Fixtures · ' · · .' ', · ,- .' , .. '..., ....... ', ,,'"
<br /> Commercial " · ' , , ,-,, ' ' ' ' '"' ' ' "·:
<br /> .................... $2.00 aa, ' ' ,
<br /> 1 ,~o'50 Fixtures ~ ...... : · · ,..
<br /> Over. 50 Fixture's ' ' ,. .......
<br /> · , , . ' ~ .' ' . . $1.00ea.
<br /> mti0ns& Additio s '
<br /> Alto n .... : - ·" · ·. · _
<br /> Charged,at Commercial Rate~ . : .... ' .
<br /> Law~ Spt nk n~ system ' ' ' ,, , ~ · .. ' : ':, '., ,... ,. .... .
<br /> · - Toand',including~a'chprotectivede'vi~e":' , ·., .' ' · .' ',' ..... . :~ ~ '.',,, ' ': $2.00 '"' · ·., ,
<br />................ TOTAL AMOUNT ALL ITEMS ,~c~, ~-~)
<br />' , ..... ' .... - '"
<br />' ' ,,' "" ..... · :',"' sURCHARGE '',. ·
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<br />cert fy that all plumbing work will be .done in a'ccordapoe :with applicable provisions of. Oregon Revised 'Statutes Chapters 447
<br />and 693 and app cab e codes, and ~hat ho.he p w ' be emp oyed unl~SS, licensed under ORS '69~.
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<br />............. .,~;~.r~X!~.~.,~.~.~{~.~.,7.--.:..---,--T-~----.:,::-:-.~ ....... _. ....... ......... . -.-
<br /> ~ ~ ~J ~Re?r~n ~,mp?ete Application With the 'Indicated Fee.. -
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