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Received Sy' ~ [~,) Senator Bldg. NO, 225 <br /> <br /> ,.' ~,,~ Salem Oregon97301 <br />Date .~,-I~-~ 7 ~ ~'q~ ,~ . <br /> Phone ~88~147 <br /> <br /> BUiLDiNG INSPECItON <br /> <br />INSPECTION <br /> <br />PLUMBING PERMIT APPLICATION <br /> <br />PhOne M~iling AcJ~ress~ " <br />Site No Cross Steer, <br /> A~d~ess:: <br />Phone':: <br /> <br />Job Address <br /> <br />H¢oT,,~e~ld~r ~t;~e gist r at io rl NO:: <br />Residential ~ New;: ~ Addition,' D Occupancy Uspci Building:: <br /> <br /> NO, FEE AMOUNT <br /> Sa~e.,.Price , , $20,00, <br /> Residential <br /> New co~.nstructten (each !ixture ,~ $ 9,00 <br /> Alterations (each fixture) 900 <br /> Re-tocated Re$id'~nce each fixturei ....... 4,50 <br /> Commercial <br /> .... New Con~i'ruction (each fixiure 9'00 ....... <br /> AIterations,(,~ach fixture) 9,00 <br /> <br /> Water Lines , <br /> <br />~ For the fir$~ 100 feet or fr~tion thereof 2000 <br /> For additional 100 feet 15,00 <br /> Sewer Service Lines <br /> First 100 feet or ir'action thereof 30,00 <br /> Additional 100 feet 15,00 <br /> Mobile Home sewer/water connexion <br /> (maximum $ feet Jennie) ..... 25,,00' <br /> Other (as per OSPSC and Building Official) <br /> On-Sit~ Technical'Review (~pply at Marion Cpunty only) .... <br /> Re-lnspectioq,,Fee 2500 <br /> FEE $ '~ 420 <br /> STATE SURCHARGE <br /> PLAN REVIEW FEE $ <br /> INVESTIGATION FEE $ <br />Please return COMPLETE APPLICATION FLEET SURCHARGE $ ,~. ~'~'"~ <br />with the indicated fee, CITY FEE $ <br /> <br />I ~m a registered builder OR (~/~ the aulherized represemagve of SIGNATURE OF APPLICAN~'-'~ ~ <br />a registered builde~ <br />The work will bs performed by a registered builde~ <br />Other <br />I agree to Install according to the s~bmitted plans and specifications: the laws of the state of Oregon and the ordin~ncee of Marion County <br /> <br />Rev 12J87 <br /> <br /> <br />