Laserfiche WebLink
FOR OFFIC~ .U$£ 9NLY <br /> <br />PLUMBING PERMIT APPLICATION <br />Please complete all Sections, 1 through 5 <br /> <br /> 1. LOCATION OF INSTALLATION <br /> <br />pERMITS APE NON.TRANSFI~P, ABLE AND NON.KEFUNDABLE AND <br />EXPIRE IP WORK IS NOT STAll,TED WIT!41N 1~;0 DAYS OF I§SUANCE <br />OP. IF WORK IS SUSPENDED FOP. 180 DAYS, <br /> <br />2A, CONTRACTOR II~$TALLATIOI~ ONLY <br /> <br />Marling Address <br />Pmpclty Own*t ] Phone <br />Plumbing Board; <br /> <br /> 2B, FOR OWNER INSTALLATIONS <br /> <br />pcopea¥ Ownor%. ;o,,r,~l.~ f~,~t V~ <br /> <br />~c ins~lafion is b~ing ~ on pmpe~y I own which is no~ intended for <br />Owncda glgna~ ~/~ , <br /> <br />We will provide plan review service if you complete Section <br />5B and submit two (2) sets &plans and specificationsI with <br />this application. , <br />This optional plan review program does not suspend the <br />required submission of plans, and specifications when[required <br />by the Oregon Structural Specialty Code, Chapter 53. ' <br /> <br />Rev. 7192 <br /> <br />4, FEE SC~DULE (Complete and enter total in A1 below) <br /> [] RESmENTIAL [~ COMMERCIAL <br /> USl~ OF STRUCTURE: ~ <br /> ~w [] A~T~oCnO~ [] ^DmT~O~ [2/~Z~J~OCAnOS [] <br /> <br />NO. XFEE ~SUM <br /> <br />~BASE FEE $20.00 <br />A. tLESIDElqTIAL <br /> <br /> Single Family or multi-Family per <br /> dwelling unit (each fixture) C~ <br /> New construction . $ 9.00~ ~'' O~ <br /> Alterations --.$ 9.00 <br /> Re-located structure __ $ 430 ....... <br /> <br /> Water Lines <br /> First 100 It. or fraction thereof --.$20.00 <br /> For additional 100 It. (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 (up to <br /> max[mm 500 feet) __, $15.00 <br /> <br />B, COMMERCIAL (each fixture) · <br /> New construeti6n __$ 9.00 <br /> Alterations --$ 9,00 <br /> Re-located slmctere $ 9.00 ...... <br /> <br /> Water Lines <br /> First I00 feet or fraction thereof --$20.00. <br /> For additional I00 feet --$15.00 <br /> <br /> Sewer Lines <br /> First 100 feet or fraction thereof __ $30.00.__ <br /> For additional 100 feet __ $1S.00.. <br /> <br /> LAWN SPRINKLER SYSTEM <br /> Each protective baakflow device $ 4.$0,,, <br /> <br /> OTFIEI~ (as required by OSPSC and <br /> Building Official) <br /> <br />$, FEES <br />Al. Enter total of fees from Sec, # 4 <br />A2. Add 5% surcharge (,05 x Al) $ ~_ ,.~-' <br /> Subtotal $ <br />B. Enter 25% of line Al for PI~ Revi~ <br /> (.25 x Al) ~requffed $ <br /> C- Investigation Fee (i~requi~d) $ <br /> b. ',,Xc~;i~,, Fee ~ ~ $ <br /> <br /> TOTAL AMO~T DUE $ <br /> Receipt No. 3~2,~ <br /> <br /> <br />