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MARION COUNTY BUILDING INSPECTION <br />Senator Bldg. No,, 229 <br />220 High Street NE <br /> Salem, Omgan 97301 <br /> <br /> Phone 588-5147 <br /> Code-A-Phone 4:90 EM,, · 9:00 A,,M, <br /> <br />PLUMBING PERMIT APPLICATION <br /> <br /> iReglstratlon NO,,' <br /> <br />Residential. [~ /New E~ .... A'ddlt[on "' [] <br />Commercial [] Alteration [] Re/oeatloa.' [] <br /> <br />Mailing Address.. <br />Cross Street:: <br /> <br />.... Oc0upan~,/ I UseOfBuilding. <br /> Change::E3 .~,,]~,,~_/~ ~J~--~v'~"-~ ~ <br /> <br /> AMOUNT <br />Base Price $2000 <br /> <br />' New constiuc/ion (each fi'xt~re) <br /> <br /> Alterations (each fixture) <br />Re-located Residence (each fixture) <br />Commercial <br /> <br />New Construction each fixture) <br /> <br />Alterations (each fixture) <br />Water Lines <br /> <br />For the first 100 feet or fraction thereof <br />For additional 100 feet <br /> <br />Sewer Service Lines <br /> First 100 feet or fraction thereof <br /> <br />(maximum 5 feet tength) <br /> <br />Other (as per OSP$C and Building 0.fficiel) <br />On-Site Technical Review (apply at Marion County only) <br /> <br />Fee .......... <br /> <br />Please return COMPLETE APPLICATION <br /> <br />NO, FEE <br /> <br /> $ 9.00 <br /> 9,00 <br /> 450 <br /> <br /> 9 O0 <br /> gO0 <br /> <br /> 20.00 <br /> 1500 <br /> <br /> 30,00 <br /> 15.00 <br /> <br /> 25,00 <br /> 2500 <br /> <br /> FEE <br />STATE SURCHARGE <br />PLAN REVIEW FEE <br />INVESTIGATION FEE <br />FLEET SURCHARGE <br /> <br /> with the indicated fee,, C~TYFEE $ , ,g~-, OD <br /> <br />{' ) eg~ u'~ R( ) u~h~ ~pm~ a~o ATU A LICA <br /> aregistemdbuilder ~ ~ / ~ / /~ ~ ~ ~ <br />( ) ~e work wii[ be performed by a registered builde~ ~ <br />(X) Other ,,. <br />(~ I agree to I~ali a~ordlng to the ~ubmitted plans end specifications, the taws of the state ~ Oregon and the o~inances of Madon Co~ty <br /> <br />MC 1 <br />Rev 12~87 <br /> <br /> <br />