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/') /' ,~,1~ 15,~QN COUNTY BUILDING INSPECTION <br /> '~ ~"' 220 High St~ NE <br />/~~~ ~ ~,~ Salem, O~on97301 <br /> <br /> ~.~-~ '_ ,~ X'%> <br /> $~0~ PLUMBING PERMIT APPLICATION <br /> <br />Phone: <br /> <br />S~fe No, <br /> <br />Residential; ~ New; ~ Addition: [] <br />Commercial: J'~ Alteration: [] Relocation: [] <br /> <br />Change: [] : :: <br /> <br /> NO. ' FEE AMOUNT <br /> Base Price $20.00 <br /> Residential ' <br /> New constructig[~ ,!each fixture) . $ 9:0,0 <br /> Alterations (each fixture) 9,00 <br /> Re-located Residence (each fixture) 4.50 <br /> Commercial <br /> New Construction each fixture). 9,00 .,. <br /> Alterations (each fixture) .. 9.00 <br /> Water Lines <br /> "Forthefirst..100feetorfractlonthor~)i ...... "' ~ 20.00 <br /> For additional 190 feet 15.00 <br /> Sewer Service Lines <br /> Fimt 100 feet or fraction th~.reof ' / $0,00 ,,,,,~ (~, <br /> Additional 100 feet 15,00 <br /> Mobile Home sewer/wafer connection '. · , ,, <br /> (maximumSfeetlesgth) ';' ' 25.00 · · · " <br /> Other as per OSPSC and Saildlng Official) <br /> On-Site Technical Review (apply at Marion County only) <br /> Re-hlspection Fee , 25,00 - <br /> FEE ~ <br /> STATE SURCHARGE <br />PLAN REViEWFEE $ <br />iNVESTI~A~ION' FEB $ <br />PleAse return COMPLETE APPLICATION FLEET SURCHARGE $ ,..~, <br />$ ' <br />with the indicated fee. C~TY FEE <br />TOTAL <br /> <br />( ) Other <br /> <br />MC 15-45 <br />Rev. 12/87 <br /> <br /> <br />