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MARION COUNTY BUILDING INSPBCTION <br /> <br /> t~l~~~N 285 Chu~ St ~' R~m 132 <br /> FO ........ ~'5~ . l Sal~, OR 97301 <br /> <br /> ~: / ~/~1~ <br />[ ' V ~ r I I ~ 24 hr. ln~ection Line 37~27 . __ <br /> . I = . [ ~ O~:PhoneS~-5147 8:00am-4:3~m <br /> <br /> PLUMBIN~ PERMIT APPLIGATION .... <br /> ~o comp/oto ~ ~Oons, ~ thrOUgh o [ <br /> co~c~ <br /> 1. L~ATION OF ~~ON ~U~I - <br /> <br /> 1 <br /> <br />P~ A~ NON-~~ ~ ~ ~ WO~ IS N~ <br /> ST~ ~ 1~ DAYS OF ISSU~ OR <br /> WO~ IS SUSP~ FOR 1~ DAYS. <br /> <br />2A. CONTRACTOR INSTALLATION ONLY <br /> <br />2B. FOR OWNBR INSTALLATIONS <br /> <br />Pmper~y Owner (pl~o prira) <br /> <br />Mailing Add~ J Phone <br />City/Stata0'Zip <br />Own~'s Signattrm: <br />Agent's Signatum: <br /> <br />3. PLAN REVIEW $]~°TION <br /> <br />Marion County does not require a plan review. <br />We will provide plan review service ifyun complete <br />Section 5B and submit two (2) sets of plans and <br />specifications with this application. <br /> <br />MC 15-45 <br />Rev. 1/96 <br /> <br />USII OF <br />NEW D ALTERATION IZI ADDITION ~ RELOCATION n <br /> <br />BASE FEE ~0.00 <br /> <br />RESIDENTIAL (each Fixture) <br />, ~,~ra Dwelling Plumbin~ Fee O~t-d"~q. fi. x $.070 = <br /> <br /> Altaratiom $10.00 __ <br /> <br /> For ea. ndd~l' 100 ft. (up to <br /> maximum orS00 ft.) $15.00 -- <br /> <br />Sanitary & Storm Lin~ <br />F'gst I00 fl. or fraction thereof $30.00 -- <br />For addnl' 100 fl. (up to <br />maximum of 560 ~) SIS.IX) -- <br /> <br /> N~w cons~uctlon $10,00 -- <br /> <br />$25.00 -- <br /> <br />Sanitary & Storm Lines <br /> First lO0 fl. or fraction thc~of <br /> For addnl' 100 fl. <br /> <br />$30.00 -- <br />$15.00 -- <br /> <br />PROTECTFCE BACKFLOW DEVICE <br /> Lawn vacuum br~ak~ (sp~r syatam).__ <br /> All olhera <br /> <br />$4.50 <br />$10.00 -- <br /> <br />O'rl~R (e,~ requirodbyOSP~7 <br /> end Buil&'~g Ol~¢iel) <br /> <br />DWELLIHO Pi/RMIT LABI/L # of Lab~l~ <br /> <br />N/C <br /> <br />5. F~S <br /> Al. Enter total of f~ea from Se~. #4 <br /> A2. Add 5% surcharbm (.05 x Al) <br /> ~bt~.al <br /> <br /> B. ~t~ 25% of l~e A 1 for Pl~ Re~cw <br /> (Al + ~5), <br /> C. Invesfiga~on Fe~ (if ~qu~ <br /> D. ~pcc~ Fee (~.~) <br /> <br /> ~T~ ~O~ D~ <br /> ~ipt No. <br /> <br /> <br />