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Application Received
<br />Date "
<br />
<br />APPLIC
<br />
<br /> '220,HIGH ST. ,N.,E~
<br />SAI~EM~ ORI~GON;97301
<br />
<br />B.Idg.. Perm
<br />
<br />Plbg, Permit.#'
<br />
<br />or not
<br />
<br />PLUMB1 NG ,i
<br />BUS1NI-"$$
<br />|UCENS~ NO-
<br />
<br />Job
<br />
<br />HOME BUI LDER~
<br />IREGISTRAION'1~Oi
<br />
<br />Address
<br />
<br />Phone ,-
<br />
<br />.......... ..... ~ "' ~ : ''' ......... I".NO OF I.TEM,.S'." ': 'FEE'ON EAcH ' feTAL AMOUNT
<br />, . ' . :TYPEOFEERMIT, ', .',, ' .· . ~ ,,.' ', ~' ';, ,.,~,-; :": ,,
<br />Base Price , , . · , ' , ~ '" ' ...... ','$ 5~00
<br />Resi'dantial, , " ' , ',: : ' .' ' ,
<br />Kitchen On'it includes'WaterHeater'- " · ' ,. ,.' ,. , · .... $4.00 .
<br />...... :.'.,:' '.. ,,/,:. :: ', , ss,0 ~'~' :~
<br />8ath Unit' full ' '. '' ' ' "
<br />.Bat~. L~nit (half) . ..........
<br />Un. it. ,. $3.00 , .,
<br />' Laundry ,
<br />Miscellaneous'Fixtu. r. es' , · ', , . , ,.,' ,,' .' .:,., ',' $2,00,,.' ,
<br />Sewer Service Line i'"~ . ' ..... '"' ,' ...... ......... $3.00'- ' ' ....
<br />........ $5.oo
<br />Wi~h Plumbing Turn-arb.'.n~t" ' ., , ' ", ,.' '" '
<br />Commercial ' , . ' ' , '
<br />' .......... ,' .' ': · "' $2o0La' I
<br />' ,ltoF,0Fixtures. · :... ,- ~., ......... ....,,-...-, ,,,-. ,.. .~ , ·" ,
<br />· : ' ' ...." ' ......... ' ' $1.00 ea.' ' '
<br /> ' Over 50'Fixtures · . ...... , :. :',' ,...' , ·
<br /> Aterat o 8~ ' ' '
<br /> ns 'Additions , , . , - , ., ,, ,.
<br /> Charged ~ ' ' ..... ~ "'"' ..... '""' ' ' ' :': .... '~ ......
<br /> Commercial Rates .~.,
<br /> LaWn Sprinkling System
<br /> To and ~ncludmg each protec[we, device, , · ...,, . ,: ' ,$2,00
<br /> ' ....
<br /> ".." ,:'"'
<br /> ,. "'..." '.,": '.: ,.":
<br />
<br />I certify th~/~l plt~mbing Weak'will.be done,in'~
<br />and 693 and/ap~l cable codas 'and .tl~at ;. ~ help"wil
<br />
<br /> /t~' ~~"~.1/ ,'., .,' '.., .:..':-., ...'.... ~ ,, , ',-,: ..... ;' ,',, , ,,,
<br /> ~/ Return' Complete .Applicati0n · With ,' the ;.!ndi~atetl ~' Fee, ,.,
<br />
<br />Statutes Chapters 447
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