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Application Received
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<br />°ate
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<br />Application Approved
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<br /> Marion County
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<br />DEPT. OF BUILDING INSPECTION
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<br /> 3180 CENTER STREET N.E.
<br /> SALEM, OREGON 97301
<br /> 588-E147
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<br />APPLICATION FOR PLUMBING PERMIT
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<br />Bldg, Permit ~ -.~ ~.3.*~
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<br />Ptbg, Permit # ,,, ~ '7 '
<br />Permit Fee ~ / ~, ~0
<br />Surcharge ~,-
<br />Receipt ~
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<br />NOTE: Applicants must hold Oregon Registration to condu~ a plumbing business [] or muS~ be property owner/operator not
<br /> hiring outside help ~. Indicate status.
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<br />~USI NESS
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<br />Address__
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<br />Phone
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<br />ph o n e~* ~;~/?
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<br /> TYPE OF PERMIT NO. OF ITEMS FEE ON EACH TOTAL AMOUNT
<br /> Base Price .... $ ~,,00
<br /> R.~idential
<br /> K,,[tchen LJnit ,,,,,!.ncludss Water,, Heater ' , ........... $4,'00 ,z-/. ~ ~ __
<br /> Bath U,0it (full) ....... $5.0,C)
<br /> Bath Unit half) $3.00 ,,, ~ ~ ,~_
<br /> ...... Laundry Unit ...... $3,,00 ....
<br /> Miscell~n.~ous Fixture~ ....... $2.00 ....
<br /> Commercial
<br /> 1 to 50 Fixtures ...... $2,,00,,.ea,
<br />~A Over,~0 Fixtures '',i' ,, $1,,0,0ea,
<br />Iterations & Additions .........
<br />Lj_,~.~.n Sprinkling b~rstem
<br />JT~ a,ed incl u~ing cacti.protective d~vice $2,00
<br /> TOTAL AMOUNT ALL ITEMS
<br /> SURCHARGE
<br /> GRAND TOTAL /~..~, ~ ~_~
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<br />I certify that all plumbing work will be done in accordance with applicable provisions of Oregon Revised Statutes Chapters~;47
<br />and 693 and applicable codes, and that no help will be employed unless licensed under ORS 693. / ~D- . c~ ~
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<br />...........~/.._.~'.._;/_~. .................... ~C_____, ~,,.Z-;/~c_~.,.o,,..~.a..r,...,' ......................... . ................................................................. .Z'_~ .............. -- / ~-;~ ..;* ,~¢' ...................
<br /> t~e~urn Complete Application With the Indicated Fee.
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