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Received <br /> <br /> LOMBiNG PERMIT PPLiOA ION <br /> <br />1. LOCATION OF INSTALLATION <br /> <br /> 2A, CONTI~,CTOR IN$~TALLAT[ON ONLY <br />Contra~to~ ~7~' I Phone <br />Mailing Address <br /> <br /> 2B. FOR OWNER INSTALLATIONS <br /> <br /> / <br /> <br />We will provide~ ~view ~ice if you complete Section <br />5B ~d submit ~ 2) <br />~is application. <br /> <br />This optional plan review program does not suspend the <br />required submission &plans, and specifications when required <br />by the Oregon Structural Specialty Code, Chapter 53. <br /> <br />2/92 <br /> <br /> Issued by: <br /> <br />4. FEE SCI~E~ULE (Complete and enter total in A1 l~low) <br /> m S D rnAL <br /> <br />NO. XFEE =SUM <br /> <br /> $20.00 <br /> <br /> BASE FEE <br /> A, RBSIDENTIAL <br /> <br /> Single Fantfly 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 10O ff. or fraction thereof <br /> For aclditional 100 tr. (up to <br /> maximum of 500 feet) <br /> <br /> Sewer Lines <br /> First 100 feet or fraction thereof <br /> For additional 100 feet (up to <br /> maximum 500 feet) <br /> <br /> B. COMMERCIAL (each fixture) <br /> <br /> New con~tmction <br /> Alterations $ <br /> Re-located structure $ 9,00 . <br /> <br /> Water Lines <br /> First 100 feet or fraction thereof --$20,00 <br /> For additional 100 feet $15.00-- <br /> <br /> Sewer Lines <br /> First lOO feet or fraction thereof ~$30.00~ <br /> For additional 100 feet $15,00. <br /> <br /> C. LAWN SPRR',W..LER_ SYSTEM <br /> <br /> Each protective backflow device <br /> <br />D. ~O .2?/~.ER (as re~Iuircd by OSPSC and <br /> ~uiioing Offimal) <br /> <br /> ~$20.00~ <br /> <br /> $15.00~ <br /> <br /> I $3o.o02a~.a~ <br />~$~$.00---- <br /> <br />5. FEES Al. Enter total of fees from Sec. # 4 <br /> A2, Add 5% sm'charge (.05 x Al) <br /> <br /> $ <br /> <br /> Subtelal $ <br />B, Fmter 25% oflincA1 for PlanReview .... <br /> 625 x Al) ifrequked $ <br /> C. ~vestigation [~(i~r~u~e~ $ .... <br /> <br /> <br />