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FOR CITY VALIDATIONI <br />Received by:. <br />Date: <br /> <br />MARION COUNTY BUILDING 12qSPECTION <br /> COMMUNITY DEVELOPMENT CENTER <br /> 285 Church St NE * Room 132 PERMff NO: <br /> Salem, OR 97301 <br /> Date: <br /> <br />PLUMBING PERMIT APPLICATION <br />Please complete all ~ections, I through <br /> <br />1. LOCATION OF INSTALLATION ~.~,~,~,~,~,~ <br /> <br />24 hr. Inspection Line 373-4427 <br />Office: Phone 58S~147 8:OOam - 4:30pm [ESU~[ by: <br /> <br /> 4. FEE SCHRDULE (Comp~e and ~t~ total iu A1 below) <br /> <br /> g SWEm AL COMI C_.L a / <br /> USEOF STRUCTURE: t'~.,~ r~.,~n .V~-~' <br /> NE~t~ ~ON O ~D~ION O ~OCA~ON O <br /> <br /> No, X F~ = ~m <br /> B~E PEE ~ <br /> <br />J $obNo. <br /> <br />Mailing Address <br />Plumb/n~ Bosrd: <br /> <br />Owner's Sign~ur~: <br /> <br />3. PLANRBVlBW SBCTION <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 15-45 <br />Rev. 1/96 <br /> <br />RESIDENTIAL (each fixture) <br /> Aurora l~vellinff Plumbing Fee sq. fi. x $.070 = <br /> <br />Single Family or mulll-family <br />dwelling unit <br />New con~lruclion $10.00 <br />Al~ratio~m $10.00 <br />Reconnect $ 5.00 <br />Relocated Structure $ 5.00 -- <br />Modulnr Structure $ 5,00 <br /> <br /> maximum of :~0 <br /> <br /> m~xlmum of 500 <br />COMMERCIAL (each fixture) <br /> <br />$20.00 <br /> <br />$15.00 <br /> <br />$10,00 <br />$10.00 <br />$10.00 <br /> <br />$25.00 <br /> <br />$15.00 <br /> <br />San~cy & Storm Lin~ <br /> Fi~t 100 fi, or fraction thereof <br /> For ad~l' 100 fl. <br /> <br />$30.00 <br /> <br />$15.00 <br /> <br />PROTECTIVE BACK, FLOW DEVlC~ <br />Lawn vacuum breaker (Sl~inkl~ system) $ 4.50 <br />AH others $10.00 <br /> <br />OTHER (as n~q/dced by OSPSC <br /> and Building O~eiaD <br /> <br />DWELLING PERMIT LABEL # of Labels N/C <br /> <br />5. FEES <br />Al. Enter total of f~.~ from S~, #4 $ <br />A2, Add 5% surcharge (.05 x Al) <br /> <br /> B. Eater 25% of lin~ Al for Plan Review <br /> (Al + .25), if t~quimd <br /> C. lnv~tigation Fe~ (if required) <br /> D. Reimpec flea Fee~ ($25.00) $__ <br /> <br /> Receipt No. <br /> <br /> <br />