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ON CO LDING INSPECTION <br /> ~ hDi~C~h~M~jFY~L~VELOPMENT CENTER <br />.... ~... ~A~ON~ ~- .... 2~ st NE · R~m 132 ~HMII <br /> <br />R~i~b~, [ MAR{ON COUNW ' Dine: <br /> <br /> O~ee: Phone S88-5147 8:00am - 4:3~m <br /> F~: 5~-7948 <br /> <br />JPLUMBING PERMIT APPLICATION <br />Please complete all ~ections, I through 5 <br /> <br />1. LOCATION OF INSTALLATION <br /> <br />PI~P. M1TS AR~ NON-TRANSFERABLE AND EXpIRE IF WORK IS NOT [ <br /> STARTED WITHIN 180 DAYS OF ISSUANCE OR IF <br /> WORK 1S SUSPENDED FOR 180 DAYS. <br /> <br />23. CONTRACTOR INSTALLATION ONLY <br /> <br />Plumbing Board: <br />Contractor's Board Reg. No. [ lob No. <br /> <br />FOR OWNBR INSTALLATIONS <br /> <br />Pcop~ny Owner (~loa~pd~t) <br /> <br />lsfliling A~dmss { <br /> <br />City/Star.Zip <br /> <br />Ow~r's Signature: <br /> <br />Ag~ot's Signature: <br /> <br />4. l~B SCHI~DULE (Compl~l euier {otal in Al below) <br /> <br /> R. HSIDI~TFIAL <br /> USE OF ~rKUCTUR~: <br /> NEW C{ ALTERATION <br /> <br /> Ho. X F~ ~ SUm <br />BASE FEE <br /> <br />RESIDENTIAL {each fixiu~:) <br />-- tmra Dwelling Plumb/fig FeB sqJ ft. x $.070 -- - <br /> <br />Single Family or multi-fmmily p~r <br />dwelllag unit <br />New constmetion $10.00 <br />Al~ations $10.00 <br />Reconaect $ 5.00 <br />Relocated Sm~mre $ 5.00 <br />Modular Structure $ 5.00 <br /> <br />Water Lin~a <br />Flint 100 ft. or fraction their $20.00 <br />For ea. added' 100 ft. (up to <br />maximum of 500 ft.) $15.00 <br /> <br />Sanita~' & Stoun Lin~ <br />Fimt iOO R. or fraction thereof $30.00 <br />For addnl' 100 ft. (up to <br />m~imum of 500 ft,) $15.00 -- <br /> <br />COMMERCIAL (each l'~tum) <br /> <br /> iN~w construction $10.00 <br /> Alterations $10.00 <br /> Reconnect $10,00 -- <br /> <br />Wat~ Lines <br /> First 100 ft. or fraction thereof <br /> For ea. addnl' 100 ft. <br /> <br />PROTECTIVE BACK.FLOW DEVICE <br /> Lawn vacuum breaker (sprinkler system) <br /> All others <br /> <br />OTHER (asrequiredbyOSPSC <br /> and Bulling O~i~l) <br /> <br />$15.00 <br /> <br />$15.00 -- <br /> <br />sn. o g <br />$10.00 <br /> <br /> 4q. v <br /> <br /> NIC <br /> <br />DWELLING pERMrr LABRL # of Labela <br /> <br />3. PLANRBVIBW S~TION <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 />Al. Ent~: total of faes from Sec. fi4 <br />A2, Add 5% surcharge (.05 x A 1) <br /> Subtotal $ <br /> <br />B. Eater 25% of line A1 for Plan Review <br />(Al + .25), if r~qui~ed $ <br />C. Investigation FOm (if~quired) $ <br />D. Reimpeetion Fee ($25.00) $.__ <br /> TOTAL AMOUNT DU~ $ .75,73 <br /> <br /> <br />