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A~plle~io~ Received <br />Date <br /> <br />pllcat~k~oved--~'~ <br />Date ?'.Z'?. .... <br /> <br /> Marion County <br /> <br />DEPT· OF BUILDING INSPECTION <br /> <br /> ;~lS0 CENTER STREET N.E. <br /> SALEM, OREGON 97301 <br /> 588-5147 <br /> <br />APPLICATION FOR PLUMBING PERMIT <br /> <br />.Idg,, Permit <br /> <br />PIbg. Permi, <br /> <br />NOTE: Applicants must hold Oregon Registration to conduct a plumbing business [] or must be proper[y owner/operator not <br /> hiring outside help [~, Indicate status. <br /> <br />PLUMBING <br />BUS{ NE~S <br />LICENSE NO. <br /> <br />HOME BUILDERS <br />REGISTRATION NO. ,, I <br /> <br /> / <br /> <br />Plbg,, Installer Address Phone <br /> <br /> TYPE OF PERMIT NO,, OF ITEMS FEE ON EACH TOTAL AMOUNT <br /> Sa~,~, Price .......................... $ $,00. ..... <br /> Residential <br /> 't~i'ichen Unlt I ncl~'.dg,s Water Heater ..... ' ..... $4,:(~0 ......... <br /> Bath Unit ,!,~alf) ...... $3.00 <br /> L.~ndry Unit, ............. ~3.00 ,, , <br /> Miscellaneous, Fixtures ,, , $2.00 <br /> Sewer Service Line ......... $3.00 <br /> With Plumbing Turn'-'bround ...... $5,,0.0 ,, , <br /> Commercial <br /> <br /> ....... ~1 tO 50 Fixtures .................. $2.00 ea"i .... <br /> Over SO Fixtures $1100 ca,, <br /> Alterations & Additions <br /> Chgr,ged at Comrnerc,i~l Rates .... <br />.... Lawn Sprinkling.,~ystem ..................... <br /> To and i.nc,luding each p.,rotec~'i'v'e device ..... $2.00" <br /> TOTAL A~OUNT ALL ITEMS <br /> SURCHARGE <br /> GRAND TOTAL <br /> <br />i certify that all plumbing work will be done in accordance with applicable provisions of Oregon Revised Statutes Chapters 447 <br />and ~93;~)plicabIe~es, ~; no he~p will be employed unless licensed under ORS 693, <br /> <br />......................... . ............................ ................... <br /> <br /> <br />