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ReceWe~d By:: <br /> <br />Data': <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> Sen~or Bldg, NO,, ~ <br /> 220 High Street NE <br /> <br />PLUMBING PERMIT APPLICATION <br /> <br /> Phone;; M~ing Address:: .......... n .......... <br />Job Address' Site NO :: Cross Street <br /> I ........... <br />Plum~ing Installer:; ~ Phone:: Address:: <br /> <br />Home Builder~ Registration No :: <br />Residential:: ~ New:: <br />Alteration:: Change:; <br />Commercial', ~ .................. ~ RelocatiOnS, ~ A~ 4~ ~ ,,, <br /> <br /> NO, FEE AMOUNT <br />Sase Price $20,00 <br />Residential <br />--~New construction !e~.h..fixture) ..... ~, $ 9,,00 ~ ,~, ~O .... <br />A~terat_._. lions (each fixture) ..... 900 <br />Re4ocated Residence eachfixture) 4~0.. <br />Commercial <br />New. Co..nstruction (each fixture) ............ 9.00 <br />Alterations (each fixture) ....... 900 <br />~ter Lines <br /> For the first 100 feet or fraction thereof 2000 <br /> For additional 100 feet 15 00 <br /> Sewer Sea, ice Lines <br /> First 100 feet or fraction thereof 30.00 <br /> Additional 100 feet 15 O0 <br /> Mobile Home sewer/water connection <br /> (maximum 5 feet length) ......... 25.00 <br /> Other as per OSPSC and Building Official) ..... <br /> On-Site Technical Review (apply at Marion County only) <br /> Re-Inspection Fee 2~ .0.0.. <br /> FEE $ ~. ~:~ <br />STATE SURCHARGE <br />PLAN REVIEW FEE $ <br />INVESTIGATION FEE $ <br />Please return COMPLETE APPLICATION FLEET SURCHARGE $ <br />with the indicated fee. C~TYFEE $ <br /> <br />I am performing work on a property I own or occupy <br />I am a registered builder OR ( ) the Authorized representative of <br />a registered builder <br />The work will be Derformed by a registered builder <br />Other__ <br /> <br />SIGNATUR~ (~F APPLICANT~ {~ <br /> <br />MC 15-45 <br />Rev 12JS7 <br /> <br /> <br />