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Application Received <br /> <br />[:)ate <br /> <br />Application Approved '"~" <br /> <br /> Marion County <br /> <br />DEPT. OP ,NSPECTIO. <br /> <br /> SALEM, OREGON 97301 <br /> 588.5147 <br /> <br />APPLICATION FOR PLUMBING PERMIT <br /> <br />BIdg,, Permit # ."~.~ ~'~-~' <br />PJbg, Permit ¢ <br />Permit Fee <br /> <br />Surcharge <br /> <br />Receipt # '~ <br /> <br />NOTE: Applicants must hold Oregon Registration to conduct a plumbing business [] or must be property owner/operator not <br /> hiring outside help []. Indicate status. <br /> <br />Address '~ Phone <br /> <br /> TYPE OF PERMIT NO. OF ITEMS FEE ON EACH TOTAL AMOUNT <br /> <br />Base Price $ 500 <br />Residential <br /> Kitchen Unit Includes Water Heater $4.00 <br /> Bath Unit (full) $5.00 <br /> Bath Unit (half) $3,00 <br /> $3.00 <br /> <br />Laundry Unit <br /> <br />$2,00 <br /> <br />Commercial <br />1 to 50 Fixtures $2.00 ea, <br />Over 50 Fixtures $1,00 ca, <br />Alterations & Additions <br />Charged at Commercial Rates <br />Lawn Sprinkling System <br />--To and including each protective device $2,00 <br /> <br />TOTAL AMOUNT ALL ITEMS <br />SURCHARGE <br /> <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 693 and applicable codes, and that no help will be employed unless licensed under ORS 693. <br /> <br />........................................................ ........................................................................ ......... <br /> Return Complete Application With the Indicated Fee. <br /> <br /> <br />