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. ~Receive'd' By; ~ <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> <br /> Senator Bldg. NO. 225 <br /> 220 Sigh Street NE <br /> Salem, Oregon g790~ <br /> <br /> PhOne $88-S147 <br />Code-A-Phone 4:,30 EM. - 8:00 A.M, <br /> <br />Owner: ~ ~''' Phone: Mailing Ad~,dmss: <br />Job Address: <br /> <br />Plumb,~ ,~ctaller; . Pho~z . . Add'ess; "' <br />Nome ~uilders Registration No. '-' <br /> <br />Residential: ~ New: ~ " <br />Addition: ~ ' Occupancy Usher Building: , <br />Com~erclal;: Alterat,o.: 0 Relocation; D Change: ~ <br /> <br /> NO. FEE AMOUNT <br /> Base Price $20.00 <br /> Residential <br /> New construction each fixture ~ $ 9.:~0 ~;>~." ~ <br /> Alterations (each fixture) 9.00 <br /> Re- ocated Res dance (each fixture) 4.50 <br /> Commercial ..... <br /> New Construction (each fixture) 9.00 <br /> Alterations (each fixtun~ . 9.00 -- <br /> Water Lines <br /> For the first 1 O0 feet or fraction thereof ' ~0,00 <br /> For additional 100 feet "' <br /> 15.00 <br /> Sewer Service Lines " <br /> First 100 feet or fraciion thereof " 30.00 <br /> Additional 100 feet 15,00 <br /> Mobile Home sewer/Water connection <br /> <br />r (maximum 5 feet length) 25.00 <br /> Other (as per OSPSC and Bulldin9 Official '" <br /> On-Site Technical Review (apply at Marion County only <br /> Re-lnsgection .Fee 25.00 <br /> FEE '$ ,~. O'S-- <br /> STATE SURCHARGE ~, ~'~ <br /> PLAN REVIEW F~E $ <br /> INVESTIGATION FEE $ <br />Please return COMPLETE APPLICATION ' FLEET SURCHARGE $ ~'. ~ ~ <br />with the indicated fee. C~TY FEE $ ;;~. ~ <br /> <br />{ am a registered builder OR ( the auth0rlzed reu~esentative of ${(~NATURE OF APPLICANT: <br />a registered builder. <br />The work will be perf~3rmed by a registered builder. <br /> <br />I agree to install accenting to the submitteo ~ans an~] specifications, the lawe of the state ct Oregon and the ordinances ~f Marion Coun~ <br /> <br />MC 15-45 <br />Re~ 12/87 <br /> <br /> <br />