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I¢OR c IT¥' <br />Received <br />Date: <br /> <br /> PLUMBING PERMIT APPLICATION <br /> P/eass complete <br /> <br />L LOC~TIO~ OF ~ST~TION <br /> <br />COMMUNITY DEVELOPMENT CENTER <br />285 Church St NE · Room 132 <br /> Salem, OR 97301 <br /> <br />2~ Hr lnspectiou Linea 581~7904 <br />Offlae: 588-5147 8:00 a.m. - 4:30 p.m. <br />PAX; 588-7948 <br /> <br />Issued by: Ntg.~lOI~i COUNTY <br /> <br />'"l <br /> <br />~LttLO ................. <br /> <br /> pERMITS APAg NON-TRANSFER,ABLE AND EXPIRE IF WORK IS NOT <br /> STARTED WITHIN 180 DAYS OF ISSUANCE OR If: <br /> WORK IS SUSPENDED FOR 180 DAYS. <br /> <br />2A. CONTRACTOR INSTALLATION ONLY <br /> <br />Plumbing Board: <br />Con~rnctor'a Board P. eg, No, ~{ Sob No. <br /> <br />21t. FOR OWNflR. llqSTALLATIONS <br /> <br />4, F]~ $CHEDUL~ (Complete and eater total in Al below) <br /> RB8~I~ ~ CO~CI~ <br /> USg ~RUCT~B: <br /> NEW~ ALTERATION ~ ADDITION ~ 'R~ocATION <br /> <br />R.ESlDIgNTiAL (~aeh fixture) ~ <br /> iqllD <br /> Aura. Dwelling PlumbJ,g Fee : sq, ft. x $.065 =-__..c"~_ -- <br /> <br /> New a~nstCn¢lioa / $10.00 ---- <br /> Alteratlooa $10.00 ..... <br /> <br />$20,00 <br /> <br />$15.00 ..... <br /> <br />$30,00 <br /> <br />$ I$,00 -- <br /> <br /> For ~a. ad~W 100 fi, (up to <br /> maxixnuin of 5(X~ fl,) <br /> <br /> ~>r addnl' 100 ft. (up to <br /> maxJllltan of 500 IL) <br /> <br />COMMERCIAL (eaCh axmr¢) <br />N~w constcu~tion $10.00 <br />Reconnect $10.00 <br /> <br /> maximum 0£500 it.) $15.00 ..... <br /> and Building <br /> <br />3_ PLAN RI/VIEW SECTION <br /> <br />Marion County does not require a plan review, <br />We will provide plan review service if you complete <br />Section 5B and submit two (2) sets of plans and <br />specifications with this application. <br /> <br />MC 15-4.5 <br />Rev. 124'94 <br /> <br />Add 5% su~har~ (.05 X Al) $~ <br /> <br /> TOT~ ~O[I~ DUE Sm~~ <br /> <br /> <br />