Laserfiche WebLink
Igoa ogg. c usr o ¥1 <br /> <br />IPLUMBING PERMIT APPLICATION <br /> P/ease complete all Sections, 1 through 5 <br /> <br /> 1. LOCATION OF INSTALLATION <br />Job Addwss <br /> <br />MARION COUNTY BUILDING <br /> <br /> Salem, Oregon 97301 <br /> <br />Phone 588-5147 S;00a,m.~4:30p,m, SITE #: <br /> <br />Directions <br /> <br /> PERMITS ARE NON-TRANSFERABLE AND NON-REFUNDABLE AND <br /> EXPIRE iF WORK IS NOT STARTED WITHIN 180 DAYS O)? ISSUANCE <br /> OP. IF WORK IS SUSP~OND~D FOP, ! 50 DAYS, <br /> <br /> ZA. CONTRACTOR INSTALLATION ONLY <br /> <br />2B. FOR OWNER INSTALLATIONS <br /> <br />Tho installation is being made on property I own which is not intended for sale, <br />Own,r'~ Signature <br /> <br />3, PLAN REVIEW SECTION <br /> <br />r,'~x: 5SS-79dS d Date: ._~.,,m nlt~C. INSPE~'llolq <br /> ...... <br /> 0 Issued by: <br /> <br /> 4. ~ S<~E (Complete ~d ~ter to~ in Al ~low) <br /> ~ ~AL~ON ~DI.ON ~EL~ON ~ <br /> <br />NO, X FEE = SUM <br /> <br /> $20,00 <br /> <br /> BASE FEE <br /> A, RESIDENTIAL. <br /> <br /> Single Family or multi-Family per <br /> dwelling unit (each fixture) <br /> New construction ~ $ 9.00 ,~ <br /> Alterations -- $ 9.00 <br /> Re-located structure __ $ 4.50 <br /> <br /> Water Lines <br /> First 100 ff. or fraction thereof / $20.0f~_Q~_,a~ <br /> For additional 100 ~. (up to <br /> maximum of 500 feet) --$15,00 <br /> <br /> Sewer Lines <br /> First I00 feet or fraction thereof -- $30,00 <br /> For additional 100 feet (ap to <br /> maximum 500 feet) __$15.00 <br /> <br />B. COMMERCIAL (each fixture) <br /> <br /> New Construction $ 9,00, <br /> Alterations -- $ 9.00 <br /> Re-located structure --$ 9.00 <br /> <br /> Water Lines <br /> First I00 feet or fraction thereof ----. <br /> For add/tional I00 feet · · $15,00 ...... <br /> <br /> Sewer Line5 <br /> First I00 feet or fraction thereof --.$30,00 <br /> For additional 100 feet --$15,00 <br /> <br /> LAWN SPRINT, LER SYSTEM <br /> Each protective backflow device -- $ 4,50 <br /> <br /> OTHER (as re uired by OSPSC and <br /> Bu~lcling <br /> <br />We will provide plan review ~rvice if you complete Section <br />5B and submit two (2) sets of plan5 and specifications with <br />this application, <br /> <br />This optional plan review program does not suspend the <br />required submission of plans, and specifications when required <br />by the Or~egon Structural Specialty Code, Chapter 53. <br /> <br />,'lC 15~45 <br /> <br />Rev, 2/92 <br /> <br />5. FEES Al. Enter total of fees from Sec. # 4 <br /> A2, Add 5% sutc~harga (.05 x A1 ) <br /> <br /> Subtotal <br />B, Enter 25% &line Al for Plan Review <br /> (.25 x Al) if required <br /> C. Investigation Fee tifrequired) <br /> <br /> TOTAL AMOUNT DUE <br /> <br /> <br />