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MARION COUNTY BUILDING INSPECTION <br /> ~nator Bldg. NO. 22S <br /> 220 High Street NE <br /> Salem, Oregon 97301 <br /> <br /> Phone 688-S147 <br /> Code-A-Phone 4:30 P.M,, - 8:~ A.M. <br /> <br />PLUMBING PERMIT APPLICATION <br /> <br />, Plumbing leetalle~i Phone, Address:: J~ <br /> <br /> Home Bullder~ Registration NO:: ~ 7~~ <br /> ..... NYs-5-/ <br /> "Residential;; ~/' New;; ~ .... Addition- ~ --"~cupascy Us~ of Building;; . <br /> <br /> NOi FEE AMOUNT <br /> Base Price $2000 <br /> Residential <br /> New censtructlon"(eash fixtu.,re} ......... $ 9.00 <br /> AIteratices (,~ach fixture) 9,00 <br /> Re-located Residence (each fixture 450 <br /> Commercial <br /> New Constr~tion (each fixture , , ' ......... , .......... 9100 ............. <br /> Alterations (eac,~ fixture) ......... 9,,00 <br /> '"Water Lines ................ <br /> For the first100~i~ or freetiel'{Ii~er~of...... I I'I ~0 i00 <br /> For,additional 100 feet ..... 1500 <br /> Sewer Service Lines <br /> first 100 feet or f!.astion thereof ..... .i i I .... / 30110~ <br /> Additional 100 feet 1 <br /> Mobile Home sawer/wate~"c~nnection ..................... <br /> (maximum 5 feet i!i~ngth) ~ii00 <br /> Other (as per osP$C and Building Officisl) ...... ,, , ' .... <br /> On-Site Technical Review (apply at Marion County 0 ni!iY <br />.,Re-Inspection Fe~, 25.00 <br /> STATE SURCHARGE <br /> PLAN REVIEW FEE $ <br /> INVESTIGATION FEE $ <br />Please return COMPLETE APPLICATION FLEET SURCHARGE <br />with the indicated fee,, CiTY FEE ~ <br /> <br /> I am performing work on a property I own or occupy <br />( ""J~.,,i.._ i ;ma registered builder OR ( ) the authorized representative of SIGNATURE OF A <br /> ~a ~egistered builder, <br /> The work will be performed by a registered builder <br /> Other <br /> I agree to install a~¢ording to the subrniffed plans and s~)ecltlcations, the laws of the state of O~egon aris the~rdinancas of Marlor!t~)anty, <br /> <br />MC 15-4g <br />Rev 12/87 <br /> <br /> <br />