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FOR. 6FFICE~U. ,SE,~qpNLY] <br />Received by:~~ <br /> <br /> PLUMBING PERMIT APPLICATION <br />Please complete all Sections, 1 through <br /> <br />220 H/gh Street NE <br />Salem, Oregon 97301 <br /> <br />MARION COUNTY BUILDING INSPECTIOE~[~Vf~ <br /> <br />Phone 585-5147 S:00 z-m, ~ 4:30 p.m. <br />Code-A-Phone: 585-7904 <br /> FAX: 585-7948 <br /> <br /> ..... Permit No, <br />PbYJ~. lNG INSPEC¥!O~ <br /> <br />Issued by: <br /> <br />EX PIPJ~ IF WORK IS NOT STARTED WITHIN 180 DAYS OF ISSUANCE <br />OR IF WORK IS SUSPENDED FOR 1 S0 DAYS, <br /> <br />Property Owner <br /> <br />Mailing Address <br /> <br />City/State/Zip <br /> <br />PLAN REVIEW SECTION <br /> <br />4. FEE SCHEDULE (Comptete and eater total in Al below) <br /> [] V,~SIDENTZAL [] CO~Z~mgCInL <br /> U$1~ OF $~U~: ~ <br /> <br /> BASE FEE <br /> A. RESIDENTIAL <br /> <br /> Single Family or multi-Family per <br /> dwelling anit (each fixture) <br /> New eons~uction <br /> Alterations <br /> Re4ocated structure <br /> <br /> Water Lines <br /> First 100 fl. or fraction thereof <br /> For additional I00 R. (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, COIvRvlERCIAL (each fixtm-e) <br /> <br /> New consU~cti6n <br /> Alterations <br /> Re-located s~ructure <br /> <br /> Water Lines <br /> First 100 feet or fraction thereof <br /> For additional 100 feet <br /> <br /> Sewer Lines <br /> First 100 feet or fraction thereof <br /> For additional I00 feet <br /> <br /> C. LAWN SPRINKLER SYSTEM <br /> <br /> Each protective baekflow device <br /> <br />D. OTHER (as recjuirea by OSPSC and <br /> Building Official) <br /> <br />NO. XF~E =SUM <br /> <br /> $20.00 <br /> <br />--.$ 9.00,, <br />--.$ 9.00 <br />--$4.50 <br /> <br />--$20.00 <br /> <br />--$15.00 <br /> <br />__ ;30.00 <br /> <br />__S15,00 <br /> <br />9.00 <br />9.00 <br />9,00 ,, <br /> <br />--$20.00 <br /> <br />--$30.00 <br />--$15,00 <br /> <br />[ $ 4.50 ~-:~''D <br /> <br />We will provide plan review service if you complete Section <br />5B and submit two (2) sets of plans 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 Oregon Structural Specialty Code, Chapter 53. <br /> <br />dc 15.45 <br /> <br />Rev, 7/92 <br /> <br /> Al, Enter total of fees from Se,:. # 4 <br /> A2. Add 5% surcharge (.05 x Al) <br /> <br /> Suh, ot~l <br />B. Enter 25% of line A1 for Plan Review (,25 x Al) irre~uked <br /> C. Investigation Fee (ifrequired)~ <br /> D, Reinspectian ree~,~ <br /> <br /> <br />