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Received By ¢ ~ <br />Date //~~~ <br /> <br />:;¢ MA,,RION ~"UNTY BUILDING INSPECTION <br /> <br /> Code-A-Phone 4;30 RM - S;00 A.M <br />i "I I',','~' <br /> <br /> PLUMBING PERMIT APPLICATION <br /> <br />Job Address x, <br /> <br />Home @uilde¢s ¢~'egisttatio~ No :: <br /> <br />Ccmmerciat []_ Alteration:; [] Relocation;; <br /> <br />Phone <br /> <br />Site N~ ::' ~-'~-~ <br /> <br />Phone <br /> 97..¢- 4q¢.5 <br /> <br />Occupancy ' U,.Se of Building ~ - <br />Oha ge <br /> <br />NO, FEE [ AMOUNT <br /> $20,00 <br />¢_ ~ g':00 ,,.~.o~,,.,,5 <br /> 900 <br /> 4 50 <br /> 900 <br /> 9,00 <br /> go~ '" <br /> 1500 <br /> 30 00 <br /> 1500 <br /> 2500 <br /> <br />.... '25 00 <br />STATE SURCHARGE , <br />PLAN REVIEW FEE $ <br />INVESTIGATION FEE $ <br />FLEET SURCHARGE $ <br />TOTAL <br /> <br />Sase Price <br /> <br />Residential <br /> New construction (each fixture) <br /> A~terations (each fixture) <br /> <br />Re-located Residence (each fixture) <br /> <br />Commercial <br /> <br />New Construction (each fixture) <br /> <br />Alterations (each fixture) <br /> <br />Water Lines <br /> <br />For the first 100 feet or fraction thereof <br /> <br /> For additional 100 feet <br />Sewer Service Lines <br /> First 100 feet or fraction thereof <br /> Additional 100 feet <br /> <br />Mobile Home aewer~ater connection <br /> <br />(maximum 5 feet length) <br /> <br />Other (as per OSPSC and Building Off,cai) <br /> <br />Re. Inspection Fee <br /> <br />Please return COMPLETE APPLICATION <br />with the indicated fee <br /> <br />I am performing work on e, property I own or occup~ <br />I ~m ¢ registered builder OR { ) the authorized representati~ of SIGNATURE OF ApPLiCANT <br /> <br />The work will be~performed ~ a r~istered builder. <br /> <br />MC 15.45 <br />ReV 12/87 <br /> <br /> <br />