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, Appllcation Reaelved <br /> Appflcation Approved <br /> <br /> Marion County <br /> <br />DEPT. OF BUILDING INSPECTION <br /> <br />COURT HOUSE, SALEM, OREGON <br /> <br />Permit No <br /> <br />~ /~_ PLUMBING INSTALLATION Permit Fee <br /> -_3_ __: :_ __ ?? : ,, -1- "- / .o,, <br /> <br />Address <br /> <br />Plbg Installer <br /> <br />,Address F ~¢~/~- ~-~ ~ ~.~ ~L ~' ~/ Phone <br /> <br />APPLICATION TO INSTALL <br /> <br /> Water Closets <br /> Bath (tub) <br /> Basins No. <br /> <br />Rain Drains No. <br />· k,~ Sinks No,, <br />Laundry Trays No,, <br />Garbage Disposal No, <br /> <br />Drinking Fountains No. <br /> <br />Shower Baths No. <br />Wash Racks No <br />Drains, Stable No,, <br />Drains, Garage No. <br />Drains, Floor No. <br />Dishwasher No. <br /> <br />Urinals No, __ <br />Slop Sinks No. <br />Sump Pumps No ......... <br />Boiler Blow Off No,, <br /> <br />Refrigerator Wastes No ........... <br />Automatic Washers No ............. ( ........ <br /> <br />Water Heaters No, <br /> <br />Other Fixtures not specified above <br /> <br />REMARKS <br /> <br />~ Alter <br />agree to I Repair <br /> ¢ Install <br /> <br />the plumbing system according to the Plumbing Code of the State of Oregon. <br /> <br /> <br />