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UNTY BUILDING iNSPECTION <br /> <br /> Phone 588.5147 <br />^c.'~ ~,~1[ ~ Code-A-Phone 4::SO P.M. - S:O0 A.M. <br /> <br /> PLUMBING PERMIT APPLICATION <br /> <br />Phone;; <br /> <br />Site NO <br /> <br />Phone <br /> <br />~Address: <br /> <br /> New []~,"/ Additi~'n: [] <br />Commercial [] Alteration:: [] Relocation;: [] <br /> <br />Chaoge rqO~cup~;~c~ 'J ~_F..~-~U~e of Bulldlng:: <br /> <br /> HO,, FEE AMOUNT <br /> Base Price $~0,,00 <br /> Residential <br /> Al__t.,e.?tion~ (each fixture) 900 <br /> Re-located Residence (each fi~xt.~re) 4,50 ....... <br /> Commercial <br /> New Construction (each f_i,x.t.u,re), ----" 9 O0 <br /> Alterations (ea~,fixture) ............ 900 <br /> Water Lines <br /> For th~!!mt, 100 feet or fraction thereof 20,00 ~. {~'~" <br /> For additional 100 feet 15 00 <br /> Sewer Service Lines <br />First 100 feet or fraction thereof 3008 .~ O, ~)(~ <br />Additional 100 feet 15 00 <br />Mobile Rome sewer/water connection <br />(maximum 5 feet length) ............. ¢_500 <br />Other (as per OSPSC and Building Official) <br />On-Site Technical R,?ieW (aPpl~ a~'~;~i~n County only ...... ' ..... <br />[. Re-inspection Fee ;~5 O0 <br /> <br /> STATE SURCHARGE ~' ~'~ <br /> PLAN REVIEW FEE $ <br /> INVESTIGATION FEE $ <br />Please return COMPLETE APPLICATION FLEETSURCHARGE $ ,...~. <br />with the indicated fee. CITY FEE $ .~* <br />TOTAL <br /> <br />() I am performing wed< on a property I own or occupy ~,~ <br />( ~ larnareglstoredbuilderOR( )theauthorizedrepresent~tiveof SIGNATUR£OFAPPLICANT <br /> a rogisteced builder ~¢/ <br />() The ~vork will be performed by a registered b~tlde~', <br />tt ~. Other <br /> I agree ~o Install 8ccordfn¢ to tl~e submitted plans and specifications, the I8w$ of the State of Oregon and the ordinances ef M~rion County ~'~ <br /> <br />MC 15-45 <br />Rev 12/87 <br /> <br /> <br />