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Received (.~ MARION COON'FYsenatorBUILDINGmag. ,o. 2= INSPECTION <br /> ~elem, O~on 97301 <br /> Phone 58~5147 <br /> <br />PLUMBING PERMIT APPLICATION <br /> <br />MARION COUNTY <br />BUILDING INSPECTION <br /> <br />Owner: Phone; Mailing Address: <br /> Brady Sheets 503/632-4359 PO Box 18, Aurora <br />Job Address; SiM No,; <br /> 14996 Third St., Aurora <br /> <br />PJumbin~ installer; <br /> self <br /> <br />Home Builder's Registration No,: <br /> <br />Residential: i'~ New; <br />Commerci21,!,..,? ........... Alteration'. <br /> <br />CROSS Street; <br /> Liberty <br /> <br />Address; <br /> <br />Addition; [] Occupancy Use of Building; <br />Relocation: [] Change; ~ residence <br /> <br />(× <br /> <br />Base Price <br />Residential <br /> <br />New construction (each fixture) <br /> <br />Alterations (each fixture) <br /> <br />Re-located Residence (each fixture) <br /> <br />Commercial <br /> <br />New Construction (each fixture) <br /> <br />Alterations (each fixture) <br /> <br />Water Lines <br /> <br />For the first 100 feet or fraction thereof <br /> <br />For additional 100 feet <br /> <br />Sewer Service Lines <br /> <br />First 1oo feet or fraction thereof <br /> <br />Additional 100 feet <br /> <br />Mobile Home sewer/water connection <br /> <br />(mAximum 5 feet length) <br /> <br />Other (as per OSPSC and Building Official) <br />On-Site Technical Review (apply at Marion County only) <br />Re-Inspection Fee <br /> <br />Please return COMPLETE APPLICATION <br />with the indicated fee. <br /> <br />NO. FEE <br /> <br /> $ 9.00 <br /> 9 g,oo <br /> 4,50 <br /> <br /> 9.OO <br /> 9.00 <br /> <br /> 20,00 <br /> 15.00 <br /> <br /> 30.00 <br /> 15.00 <br /> <br /> 25,00 <br /> ~5,00 <br /> <br /> FEE <br />STATE SURCHARGE <br />PLAN REVIEW FEE <br />INVESTIGATION FEE <br />FLEET SURCHARGE <br />CITY FEE <br /> TOTAL <br /> <br />SIGNA"rURE OF APPLICANT: ,~£~_.--~_ ~_~ <br /> <br />AMOUNT <br /> $20,00 <br /> <br /> 81.00 <br /> <br /> 20.00 <br /> <br /> 121.00 <br /> ...... <br /> <br />MC 15-45 <br />Rev, 12/87 <br /> <br /> <br />