Laserfiche WebLink
FOR CITY VALIDATION <br />Received by: <br />Date: <br /> <br />MARION COUNTY BUILDING INSPECTION <br />COMMUNITY DEVELOPMENT CENTER <br />285 Church St NE · Room 132 <br /> Salem, OR 97301 <br /> <br /> 24 hr. Inspection Line 373-4427 <br />Office: Phone 588-5147 8:00am - 4:30pm <br />FAX: 588-7948 <br /> <br />PLUMBING PERMIT APPLICATION I <br />Please complete all Sections, I through 5 <br /> I <br /> <br />1. LOCATION OF INS'rALLATION <br /> <br />Description/Directions: <br /> <br />PERMITS ARE NON-TRANSFERABLE AND EXPIRE IF WORK IS NOT <br />STARTED WITHIN 180 DAYS OF ISSUANCE OR IF <br /> WORK IS SUSPENDED FOR 180 DAYS. <br /> <br />Job No. <br /> <br />2A. CONTRACTOR INSTALLATION ONLY <br /> <br />2B. FOR OWNER INSTALLATIONS <br /> <br />Property Owner (ple~seprint) <br /> <br />Mailing Address I Phone <br /> <br />City/StateTZip <br /> <br />Owner's Signature: <br /> <br />Agent's Signature: <br /> <br />3. PLANREVIEW SECTION <br /> <br />PERMIT NO: <br /> <br />Date: <br /> <br />Issued by: <br /> <br />4. FEE SCHEDULE (Complete and emer total in Al below) <br /> <br /> RI~E~AL [] COMMERCIAL [] <br /> USE OF STRUCTURE: <br /> NEW [] ALTERATION [] ADDITION r-I RELOCATION [] <br /> <br /> No. X Fee -- Sum <br />BASE FEE $20.00 <br /> <br />RESIDENTIAL (each fixture) <br /> Aurora Dwelling Plumbing Fee <br /> <br />__.sq. fi. x $.070 = <br /> <br />Single Family or multi-family per <br />dwelling unit <br />New construction ~ $10.00 <br />Alterations . v $10.00 <br />Reconnect $ 5.00 <br />Relocated Structure $ 5.00 <br />Modular Structure $ 5.00 <br /> <br />Water Lines <br />First 100 ft. or fraction thereof $20.00 __ <br />For ea. ad&fi' 100 ft. (up to <br />maximum of 500 fl.) $15.00 __ <br /> <br />Sanitary & Storm Lines <br />First 100 ft. or fraction thereof $30.00 <br />For addnl' 100 fl. (up to <br />maximum of 500 ft.) $15.00 <br /> <br />COMMERCIAL (each fixture) <br /> <br /> New construction $ I0.00 <br /> Alterations $10.00 <br /> Reconnect $10.00 <br /> <br />Water Lines <br />First 100 ft. or fraction thereof $25.00 <br />For ea. addnl' 100 ft. <br /> $15.oo <br /> <br />Sanitary & Storm Lines <br />First 100 ft. or fraction thereof $30.00 <br />FOr addnl' 100 ft. <br /> $i5.00 <br /> <br />PROTECTIVE BACKFLOW DEVICE <br />Lawn vacuum breaker (sprinkler system) $ 4.50 <br />All others $10.00 <br /> <br />OTHER (as required by OSPSC <br /> and Building Ot~cial) <br /> <br />DWELLING PERMIT LABEL # of Labels <br /> <br />N/C <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 />5. FEES <br /> Al. Enter total of fees from Sec.//4 <br /> A2. Add 5% surcharge (.05 x Al) <br /> <br />Subtotal <br /> <br />B. Eater 25% of line Al for Plan Review <br /> (A 1 + .25), if required <br />C. Investigation Fee (if required) <br />D. Reinapeetion Fee ($25.00) <br /> <br />TOTAL AMOUNT DUE <br /> <br />MC 15-45 <br />Rev. 1/96 Receipt No. <br /> <br /> <br />