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Renelved ,By:: <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> ~en.~r i~ldg. No, 225 <br /> <br />PLUMBING PERMIT APPLICATION <br /> <br />OW~_~.~ ...... Phone.' ' Mjtiling A..ddress:: ' ,~ , ' <br />/am. <br />Job Addres~ .......... Site No,;; C~ss Street:: ...... · / "' <br /> .... <br />ig Ins~ller: ~ . Phone' Add'ss:: <br />Home ~ui[derg Registration NO: <br />...... <br />~id~n~i~i:: ~ NOW, ~' Addition:: ~ O~pa~cy Usher Building: "~ <br />Commercial:: 0 Alteration:: = ...... ReJocatio. = Change: Z <br /> <br /> NO FEE AMOUNT <br /> $20.00 <br /> Residential <br /> New construCtion (each fixture) '" ~" ,$, 9.00 ' ' ~'~- 0 0 ...... <br /> Alterations (each,!,i?!,u,re} ...... ,900 <br /> Re-located Residence (each fixture) 4 50 <br /> Commemial <br /> .... New ConstruCtion (each fixture) ........... 900 , , <br /> Alterations (each fixture) ...... 9,00 <br /> Water Linen ............... <br /> For the first 100 feet or fraction thereo~' 20,00 <br /> For additional 100 feet 15,00 <br /> Sewer Service Lines ........... <br /> First 100 feet or fraction thereof $00o <br /> Additional 100 feet 15,00 <br /> Mobile Home sewe r/wa~:'c'~ n nectio n .......... <br /> (maximum 5 feet length) ..... 2~,:,0o <br /> Other (a? p,~,~,,(~SPSC and Building Official),. ....... <br /> On-Site Technical Review apply at Marion County only) <br /> Re-inspeCtion,Ia.e= <br /> <br />STATE SURCHARGE _~. <br />PLAN REVIEW ~EE $ <br />INVESTIGATION FE~ $ <br />Please return COMPLETE APPLICATION FLEET SURCHARGE $ <br />CITY <br />FEE <br /> $ <br />with the indicated fee,, <br />TOTAL <br /> <br />(~ a registered builder OR ( ) the authorized representative of <br /> <br />( ) The work will be performed by e registered builder <br /> ) Otl~er <br />( <br /> <br />) I~greetoinstal[a~eordingtothesubmtttedplensandspec ca ohs he awso thesateofOregonandtheo~dinancesofM~don~ounty <br /> <br />MC 15-45 <br />Rev 12/87 <br /> <br /> <br />