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MARION COUNTY BUILDING INSPECTION <br /> S~nator Bidg,, No,, 225 <br /> 220 High Btfeet NE <br /> <br /> Phone 588-5147 <br /> <br />PLUMBING PERMIT APPLICATION <br /> <br />JobAddress <br />Plumbing Installer Phone' Add,ess' <br />Home Builder~egistration NO :: <br /> <br />Resldenti~l;; ~ New;; '~ ~dition;; ~ ................... Occupancy '" '"UsegfBugding" <br /> <br /> NO. FEE AMOUNT <br /> Base Price $20.00 <br /> Residential <br /> Newconstruction each fixture ................. $ 9.00 <br /> Alferafions (easi~..!.ixture) 9..00 <br /> Re-located Residence (eash..!i.x.!ure) .......... 4.$0 <br /> Commemial <br /> <br /> r New Construction (each fixture) 900 <br /> <br /> .. Alterations (each fixture ......... 9..00 .......... <br /> Water Lines <br /> For the'~l'r~t 100 feet or fraction ~he~of ......... / 90.00 e,,~2. O ~) <br /> For additional 100 feet 15.00 <br /> <br /> F!~f 100 feet or fra~t'i~n thereof ...... ' ....... ,/ 3000 ~, ~ <br /> Additional 100 feet 15.00 <br /> Mobile Home sewer"ValOr connection <br /> (maximum 5 f~!.[ength) ......... 25.?.0... <br /> Other (as per OSPSC and Building Official ............... <br /> On-Site Technical Review apply at Marion County.?nly ......... <br /> Re4nspemJon Fee 25 00 <br /> <br /> STATE SURCHARGE ~,~, ,~ <br /> PLAN REVIEW FEE $ <br /> INVESTIGATION FEE $ <br />Please return COMPLETE APPLICATION FLEETSURCHARGE $ ,.~'"~'~' <br />with the indicated fee. CITY FEE ~ <br />TOTALs. <br /> <br />am perf~3rming work or~ a property I own Or occupy .~-,~"~' ,~ <br />~.~aP registered builder OR ( ) t he authorized ¢epresentative of 81GNATU RE OF APPLICANT: . <br />/ a registered builder ;~~ -- <br /> <br />The work will be performed by a registered builder. <br />Other <br />I agree to illstal[ according to the submitted plans and specifications, the I~ws of the stare of Oregon and the ordinances of Marion L%unty <br /> <br />MC 15-45 <br />Rev. 12.287 <br /> <br /> <br />