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Job Address <br /> <br /> Installer:: <br /> <br />Home Builder's Registration No,:: <br /> <br />Residential New:: <br />Commercial:: [] Alteration <br /> <br />Phone i Address:: <br /> <br />Addition:: [] Occupaeoy <br />Relocation I~ Change [] <br /> <br /> NO FEE AMOUNT <br /> Sase Price $2000 <br /> Residential <br /> New construction (each fixture) .~ $ 900 ,.~-'~, <br /> Alterations (each fixture ..................... 900 <br /> Reqocated Res[denc~,(each fixture) 4,50 <br /> Commercial <br /> New C o n st r u ctio n.(.,e.~ch, fixture) .... 9,,00 ............. <br /> Alterations (each fixture) 900 <br /> For the first 100 feet or fraction thereof 2000 <br /> For additional 100 feet 15,00 <br /> Sewer Service Lines <br /> First 100 feet or fraction thereof 3000 <br /> Additional 100 feet 15,00 <br /> Mobile Home sewer~vater connection <br /> (maximum 5 feet length) 2500 <br /> "Other (as per OSPSC and S"i'lding Official) ...................... <br /> On-Site Technic¢l Review (apply at Marion County only <br /> Re-inspection Fee ......... <br /> <br />STATE SURCHARGE <br />PLAN REVIEW FlEE <br />INVESTIGATION FEE $ <br />Please return COMPLETE APPLICATION FLEET SURCHARGE $ <br />with the indicated fee, C~TY FEE <br />TOTAL $ <br /> <br />a registered builder <br />The work t~ifl be performed by ~ registered builder <br />Other <br />t agreeto install according tothesubmlsed blans andspecifications,thelawsofthestateefOregon and theo~Jinanceeof MarienCount~ <br /> <br />MC 15-45 <br />Re'/12/87 <br /> <br /> <br />