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.MARION COUNTY B[JILDING INSPECTION <br /> <br />Job Add'~ess:: · Site No, Cress Stree{? ~Ir <br />PluEn~ing Installer;: ........ Phone::' <br />Home Builder'~ Registration No,, <br /> <br />Reatdentiei; ~ New;: ~ Addition;: "El Occupancy U~eofBuffdin'g:: <br />Commercial;: [] Alteration .~.. Relocattoh;: E~ Change;; I~J'~,.j..,~..C~j~, ~"'~¢',¢¢.¢~,-~//¢/ <br /> <br /> NO FEE AMOUNT <br /> Base Price <br /> Residential <br /> New construci'ion each ?x!ure ...... ¢ $ g 00 <br /> Alterations (eac.h fixture 900 <br /> Re-located Re~idenae (each flxtu[e 4,50 <br /> Commercial <br /> New Construction e~h fixture 9",'0'0 <br /> Alterations each fixture),, 900 <br /> Water Lines ...... <br /> .... For the first 'i00 feet or fraction thereof 2000 <br /> For additional i'O0 feet 1500 <br /> -- First 100 feet or fraction ther~'of $00'~ <br /> Additional 100 feet ....... <br /> 15 O0 <br /> Mobile Home ~ewerh,vater Con~ecti~n "' <br /> (max!mum 5 feet length), 2~']'00 <br /> Other (as per OSPSC and Building Official) .... <br /> On-Site Technical Review apply,at Marion C'ounty only) ..... <br /> Re-lnsp.~ction Fee ~00 <br /> <br /> STATE SURCHARGE ~. ~ ..... <br /> PLANREVIEWFEE $ <br /> INVESTIGATION FEE $ <br />Please return COMPLETE APPLICATiON FLEETSURCHARGE $ ~' <br />with the indicated fee. CITY FEE $ ~ ~4¢ <br /> TOTAL $ <br /> <br />I am a registered builder OR ( ., ..._ _.uthorized representallve of SIGNATURE OF APPLICAN <br />~ registered builder <br />The work will be performed by a registered builder' <br />Other <br />I agree to install according to the submitted plan8 and specifications the laws of the state of Oregon and the ordinances of Mari~n County <br /> <br />MC 15-45 <br />Rev 12/87 <br /> <br /> <br />