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Application Received <br />Date <br /> <br />Application Approved <br /> <br /> [Vlarion County <br /> <br />DEPT, OF BUILDING iNSPECTION <br /> <br /> 220 HIGH ST. r~. E. <br /> SALEM, OREGON 97301 <br /> 588-5147 <br /> <br />APPLICATION FOR PLUMBING PERMIT <br /> <br />NOTE: Applicants must hold Oregon Registration to conduc~ a plumbing business ~ or must be property owner/operator not <br /> <br /> IPLUMSING <br /> <br />Job Address <br /> <br />hiring outside help []. Indicate s~atus. <br /> <br />Owner Address Phone <br />PIbg. Installer '/~ ~Y-tCLJ ~ ~ ~ · Address Phone <br /> <br /> TYPE OF PERMIT NO. OF ITEMS FEE ON EACH TOTAL AMOUNT <br /> Base Price $ 5.00 <br /> Residential <br /> Kitchen Unit Includes Water Heater ....... / $4,00 <br /> Beth Unit (full) ....... ~ $5,00 / <br /> Bath Unit (half) $3.00 <br />.... Laundry Unit , , , / $3,00 . ~-OO-- <br /> Miscellaneous Fixtures $2,.qq <br /> Sewer Service Line $3.00 <br /> With Plumbing Turn-around ...... _ $5.00 - <br /> Commercial <br /> 1 to 50 Fixtures $2,00 ea. <br /> Over 60 Fixtures $1.00 aa, <br /> Alterations & Additions <br /> .Ch~r.g~d at Commercial Rates <br /> Lawn spri.n,kl!ng' System .., <br /> To and including ~ach protective device = ,. $2.00 <br /> <br /> TOTAL AMOUNT ALL ITEMS ~>~. (~ <br /> SURCHARGE <br /> GRAND TOTAL~ I'~? ,~' <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 /> Return Complete Application With the Indicated Fee. <br /> <br /> <br />