Laserfiche WebLink
Rm~iv~i by:_ <br />Date:__ <br /> <br />MARION COUNTY BUILDING INSPECTIOIxl ' <br /> <br /> 285 Church St NE · Room 132 PERMff NO: <br /> Salem, OR 97301 <br /> Date: --~ <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 <br />Please complete all Sections, I through 5 <br /> <br />1. LOCATION OF INSTALLATION <br /> <br />lobAddress <br /> <br />lob Description: <br /> <br />PI~.IVliTS ARE NON-TRANSFERABLE AND EXPIRE IF WORK IS NOT <br />STARTED WITHIN 180 DAYS OF ISSUANCE OR IF <br /> WORK IS SUSPEHDED FOR 180 DAYS. <br /> <br />2A. CONTRACTOR INSTALLATION ONLY <br /> <br /> Issued by: <br /> <br />4. i~iE SCHEDULE (Complete mad enter total ~ ~clow) <br /> <br /> ~S~E~I~ D CO~~ <br /> USE OF STRUCk: <br /> NEW ~ ~TION ~ ADDfflON <br /> <br />/oumeyman's Plumbers No. <br /> <br />Contra¢}or's Signature: <br /> <br />21t. FOR OWNER INSTALLATIONS <br />Prol~rty Owner (oleas~ print) <br />Mailing Addr~s Phone <br />City/Stete/Zip <br />Owner's Signature: <br />Agent's Signature: <br /> <br />3. PLANREVIEW SECTION <br /> <br />Marion County does not require a plan review. <br />We will provide plan review servke if you complete <br />Section 5B and submit two (2) sets of plans and <br />specifications with this application. <br /> <br />BASE FEE $20.00 <br /> <br />RESIDENTIAL (each fixture) <br /> Aurora Dwelling Plumbing Fee __~, ft. x $.070 - <br /> <br />Single Family or multi-family per <br />dwelling unit <br />New construction $10.00 <br />Alterations $10.00 -- <br />Reconnect $ 5.00 -- <br />Relocated Strucmre $ fiDO -- <br />Modular Structure $ 5.00 <br /> <br />Water Lines <br />First 100 ft. or fraction thereof $20.00 -- <br />For ea. adcinl' 100 ft. (up to <br />maximum of 500 ft,) $15.00 -- <br /> <br />Sanitary & Starm Lines <br />First 100 ft. or fraction thereof $30.00 -- <br />For addnl' 100 fi. (up to <br />maximumof500 ft.) $15.00 -- <br /> <br />COMMERCIAL (each fixture) <br /> <br /> New construction $10.4)4) -- <br /> Alterations $10.OO -- <br /> Reconnect $10.OO <br /> <br />WaterLines <br />Fint 10Ofi. orfractionthereof $25.00 -- <br />Forea. addnl' 100fl. <br /> $15.00 -- <br /> <br />Sanitary & Storm Lines <br />First 100 fl. or fraction thereof $30.00 __ <br />For addnl' 100 ft. <br /> $15.00 -- <br /> <br />PROTECTIVE BACKFLOW DEVICE <br /> Lawn vacuum breaker (sprinkler system)__ <br /> All others <br /> <br />$4.50 -- <br />$10.00 -- <br /> <br />OTHER Os raquired byOSP$C <br /> and B~il&~g Ot~cisl) <br /> <br />DWELLING PERMIT LABBL # of Labels <br /> <br />i',7¢ <br /> <br />MC 15-45 <br />Rev. 1/96 <br /> <br />5. FEES <br />Al. Enter total of fees flora Sec. #4 $ <br />A2. Add 5% surcharge (.05 x A 1) $.__ <br /> ~ubtotal $.__ <br /> <br /> B. Enter 25% of line Al for Plan Review <br /> (Al + .25), if required $.__ <br /> C. Investigation Fee (if required) $.-- <br /> D. Reimpeetion Fee ($25.00) $ <br /> <br /> TOTAL AMOUNT DUB $.__ <br /> Receipt No. <br /> <br /> <br />