Laserfiche WebLink
IFOR CITY VALIDATIONI <br /> R~::eivedby: <br /> Date: <br /> <br />MARION COUNTY BUILDING INSPF-CTION <br /> COMMUNITY DEVELOPMENT CENTER <br /> 285 Church St NE * Room 132 PERMIT NO: <br /> Salem. OR 97301 <br /> <br />2A Hr In~p~.ion Lin~: 588-7904 <br />Office~ 588-5147 8:00a.m.-4:30p.m. <br />FAX: 588-7948 <br /> <br />IPLUMBING PERMIT APPLICATION <br /> Please complete all Sections, I through 5 <br /> <br /> I-LOCATIONOFI~b~rALLATION ~¢q %q ~ <br /> c~ t~ cc~,~V [ II~- Cm~SL~ol,~ C,I~ <br /> <br />I;~xipfi~tk~s: <br /> <br />I . p~UvllTS APE NON-TRANSFERABL~ AND EXPIR~ IF WORK IS NOT <br /> STARTED WITHIN 180 DAYS OF ISSUANCE OR IF <br /> WORK IS SUSPENDED FOR 180 DAYS. <br /> <br /> 2A. CONTRACTOR INSTALLATION ONLY <br /> ConU~ctor Judson' s, Inc. I ~,o.e 363-4141 <br /> ~aili~^dar~s P.O. BOX 12669 Salem, OR 97309 <br /> <br />Plumbing Board: 24-22PB <br /> <br />Contractor', ~,rd l~cS. No. 34604 [ Job No. 2 <br />Journeyman's Plumbers No. 50420-'P <br /> <br />liB. FOR O~R ~LATIONS <br /> <br />Property Owner ~pleaseprint) <br />Mailing Addr~s ] Phone <br />City/S~awdZip <br /> <br />3. PLAN R~VIEW SECTION <br /> <br />Issued by: <br /> <br />4. F~E SCHEDUL~ (Complc~ mid ent~a' total i~ Al I:~low) <br /> <br />USE OF ffrRUCTI./RB:,. <br />NEW rq ALTERATION rq ADDITION~RELOCATION ~1 <br /> <br />l~ X F~ = ,~m <br /> <br />BASE FEE / $20.~ <br /> <br />RESIDENTIAL (each fixture) <br /> Aurora Dwelling Plumbing F~ ~. fL x $.065 = <br /> <br /> New mns~ctmn $10.~ <br /> ~t~aled Structure $ 5~ <br /> <br />Ftrst 100 fi. or fr~¢tion thereof $20.00 <br />For ca. ad~l' 100 ft. (up to <br />maximum of 500 fi.) $15.00 <br /> <br />Reeomaeet $10.00 <br /> <br />Water Lin~s <br />Fira! 100 11. or fraction thereof $25.00 -- <br />For e,a. addnl' 100 fl. (up to <br />maximum of ~00 ft.) $15.00 <br /> <br />PROTECTIVE BACKPLOW DEVICE <br /> <br />$4.50 -- <br />$10.00 <br /> <br />OTHER (asrequir~dbyOSPXC <br /> and Building O~ciaD <br /> <br />DIStiLLING PERMIT LABEL # of Labels <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 1545 <br />Re~ 12/~4 <br /> <br />5. FEES <br /> <br /> (Al + .25), if r~quired <br /> C. Investigation F~e (ifrequir*d) <br /> D. R¢inspection Fee ($25.00) <br /> <br /> TOTAL AMOUNT DUE <br /> <br /> <br />