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· 2 MARION ,,C~/LJ~ NTY BUILDING INSPECTION <br /> I ~ , Senator Bldg. No. 228 <br />Date:: ~~3 , ~: ~ =~'~ Phone 58,5147 <br /> <br /> ~{~G ~MBING PERMIT APPLICATION <br /> <br /> ............ ~lailin Address;; <br /> Owner;; Phone: <br /> <br /> Site NO :: Cress Street" <br /> P.,J~.u'nbinglnstaller,~ . _~ Phone;: <br /> ...................... <br /> ~/~ <br /> Ro~ldenti,l: ~ .............................. New;; ~ Addition:: <br />...... ...... <br /> <br /> NO. FEE AMOUNT <br /> Base Price $20 00 <br /> Residential <br /> New construction (each f!.x!~r~.! ............ ' .............. . ............. $ g '00 .... <br /> Alteratioq~ (~a~h,flx!Fre) ........ 9,00 <br /> Re.located Residence (each fixture) 4,,50 <br /> Commemial <br /> New Construction (each fixture) g 00 <br /> Alterations (each fixture) 9,00 <br /> Water Lines <br /> For the first 100 feet or fra~ion thereof ,,/ ................... ~0,00 <br /> For additional 100 feet 1500 <br /> Sewer Service Lines <br /> First 100 feet or fraction thereof .............. / 3000 ~' O, O~ ..... <br /> Additional 100 feet 15.00 <br /> Mobile Home sewer~vater connection <br /> (maximum 5 feet length) 2500 <br /> Other (as per OSPSC and Building Official) <br /> <br /> On-Site Technical Review (apply at Marion County only) <br /> Re-inspection Fee 25.00 <br /> FEB $ <br /> STATE SURCHARGE <br /> PLANREVlEWFEE $ <br /> INVESTIGATION FEE $ <br />Please return COMPLETE APPLICATION FLEET SURCHARge <br />with the indicated fee. OI.TYFEB$ ,~,5'-~ <br /> TOTAL $ ~.-~ ~/Cc <br /> <br />I am a registered builder OR ( ) the ~uthorized representative of SIGNATURE OF APPLICANT ~ <br /> <br />The work will be performed by a reglsle~ed builder, <br />Other <br /> ag eeo ~sa accord ngto hesubmtedpansandspec ca oas he ewsof hesta eofOregonend heordinancesOfMaricnC0unty <br /> <br />MC 15-4,5 <br />Rev 12187 <br /> <br /> <br />