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Received I~y;; ~ , ~ , ; t Senator Bdg No 22,5 <br /> Phone 588-5147 <br /> <br /> PLUMBING PERMIT APPLICATION <br /> <br />OwnelL ~ ' Phone;; Mg~ng At, dress:: ' <br />Job Add ess:: -- /, Site No..- Cross Street;: ~ <br /> ........... <br /> .............. .......... <br /> <br />Rasld~ntial:: ~ New;; ~ ....... ~dditiOn;; 0 Ooeup,nc~'"' Use~uildiop:: <br />Commer~i.~.:;....g Ateraton:; ~ Rel~atlon:: a . ~[~ <br /> <br /> NO FEE AMOUNT <br /> Base Price $20..00 <br /> Reddentlal <br /> New construction (each fixture) ..........:: ~'~ $ 900 ?~.;:'"~ <br /> Alterati0n.s (~h.!.i.xture) 9.00 <br /> Re-located Residence (each fixture) ................ 4..50 <br /> Commercial <br /> New Construction (each fixture) ..................... 9..00 .......... <br /> Alterations (each fixture) .............. 9..oo <br /> 'Water Lines ................................. <br /> For the first 100 feet or fraction thereof 2000 <br /> For additional 100 feet 15.00 <br /> Sewer Service Lines <br /> First 100 feet or fraction thereof 3000 <br /> Additional 100 feet 1~00 <br /> Mobile Home sewerA~ater connection <br /> (maximum 5 feet [engtll) .................................... 25.00 <br /> Other (as per OSPSC end Building Official) ........................... <br /> On-Site Technical Review (a.pply ~!..~.arion County only) ...... <br /> Re-inspection Fee 2500 <br /> <br /> STATE SURCHARGE ~ ~"~ <br /> PLAN REVIEW FEE $ <br /> INVESTIGATION FEE $ <br />Please return COMPLETE APPLICATION FLEETSURCHARGE $ .~, ~ ¥/ <br />with the indicated fee, CITY FEE $ ~.~. ~--(..,~ . <br /> <br />I am a registered builder OR ( ) the authorized representstive 0f SIGNATURE OF APPLICANT <br /> <br />The work will be performed by e registered builde~ <br />Other <br />I agree to install according tO the submiffed plans and speoifioations~ the I~ws of the state of Oregon and the ordinsncea of Made, County <br /> <br />MC t $-45 <br />Rev. 12/87 <br /> <br /> <br />