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MARION COUNTY BUILDING INSPECTION <br />sanator Bldg. NO, 225 <br />22~ High Street N£ <br /> Salem, Oregon ~7501 <br /> <br /> Phone ~88.5147 <br /> <br />PLUMBING PERMIT APPLICATION <br /> <br />Owr~. Phone" Mailing Address.. '" ~, , I <br />Job Address <br />mbing Installer ~ / Phone~ ' ~ddross ......... <br />-Home Builder~ Reg[atra~oo N0 <br /> <br /> Residential;; ~ .... New:: ~dition;: ~ 0'ccupancy Use~f Building:" <br /> Comme~l:: ~ Alteration ~ .eloeatIom U Change ~ d;~/~ ~'~,,, ,, <br /> <br /> NO, FEE AMOUNT <br /> Base Price 820 O0 <br /> Residential <br /> N,~w constructi0n_((~ach fi×~a'r~) ...... ' ...... $ 9.00 ,,, ' ...... <br /> Alterations (each fixture) 9,,00 <br />..... Re-Ieee!ed Residence (e~ch fixture)' , , "'4,,50 <br />Commemial <br />New Constr'uctien (each fixturei 9 00 <br />Alterations (each fix!~re) 9,00 ,,, <br />Water'Lines ...... <br />For the fiat 100 feet ~'~'iraction thereof .... 20,00 "' <br />For additional 100 feet 15,,00 <br />Sewer Service Lines <br />First 100 feet er fraction thereof 30.00 <br />Additional 100 feet 15,00 <br />Mobile Home sawer/water connection <br />(maximum 5 feet length) / ~5,00 <br />Other (as pe,r OSPSC and Builciing Official) <br />.,,On-Site Technical Review (apply at M~rion County only), <br />Reqnspection Fee 2500 <br /> <br />STATE SURCHARGE j, ,~...~"-' <br />PLAN REVIEW FEE $ <br />INVESTIGATION FEE $ <br />Please return COMPLETE APPLICATION FLEI=T SURCHARGE <br />with the indicated fee,, CITY FEE $ '"'/._9-,~-' ,,, <br /> <br /> ~/'~am performing work on a property I own or occupy <br />I~ lamareglstereSbuilderOR( )lheauthorizadrepresemativeof SIGNATUR~OFAPPLICANT ~/~ ~/~ <br /> <br />(~) Theworkwillbeperformed~areglstemdbuilde[ <br /> <br />MC 15-45 <br />Rev 12~7 <br /> <br /> <br />