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BUILDING f~Sp ~'f0~794s <br />PLUMBING PERMIT APPLICATION I - <br />Please complete ali Sections, I through 5 I 4. ~ scH~= ( ~!lTd ent=r,o~l ~ As b=lo,) <br /> Rr~sIDBh'T[AL at COMMlmCIAL u <br /> <br />1. LOCATION OF INSTALLATION <br /> <br />2A. CO1WI'RACTOR INSTALLATION ONLY <br />Contractor I Phone <br /> <br />Mailing Address <br /> <br />Plumbing Board: <br />ContracloFs Board Reg. No. I lob No. <br />Journeyman's Plumbem No. <br />Contractor's Signature: <br /> <br />USli O~/~;RUCTIJRIi: <br />NEW Iff ALTERATION rn ADDITION r~ RELOCATION <br /> <br /> No. X F~ ~ Sum <br />BASE FEE $20.00 <br /> <br />RESIDENTIAL (each fLxtuee) <br /> Aurora Dwelling plumbing Fee __ sq. ft. x $.070 - <br /> <br />Single Family or multi-family per <br />dwolling unit <br />New construction $10.00 -- <br />Alterations $10.00 -- <br />Reconnect $ 5.00 -- <br />Relocated Structure $ 5.00 -- <br />Modular Structur~ $ 5.00 -- <br /> <br /> Firat 1~0 t'L or fraction thereof $2L1.00 <br /> For ea. addnl' 100 ft. (up to <br /> maximum of 500 ft.) $15.00 -- <br /> <br />Sanitary & Storm Lines <br />Fi~t 100 fl. or fraction thereof $30.00 -- <br />For addnl' 100 fl. (up to <br />maximum of 500 fl.) $15.00 -- <br /> <br />COMMERCIAL (~ach fixture) <br /> <br /> New construction $10.00 -- <br /> Alterations $10.00 -- <br /> R~eonn~t $ I0.00 <br /> <br />Water Lines <br /> First SOO ft. or fraction tlmreof <br /> For ea. ad&at' I00 fl, <br /> <br />$25,00 -- <br />$15,00 <br /> <br />Sathtely & Storm Lines <br /> First 100 fl. or fraction thereof <br /> Far addnl' 100 fl. <br /> <br />$30.00 -- <br />$15.00 -- <br /> <br />PROTECTIVE BACKFLOW DEVICE <br />Lawn vacuum breaker {sprinkler system) } $4.50 <br />All others $10.00 <br /> <br />OTHER (as required by OSP~C <br /> and BaH~ng Official) <br /> <br />DWELLING PERMIT LABEL # of Lab:Is N/C <br /> <br />2B. FOR OWNER INSTALLATIONS <br />MailingAddr~s ~'0, ~O'F~ Iq~'' Phone 7~-~ <br /> <br />3. PLANRI]VIBW 8BCTION <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 />5. F~iBS Al. Enter total of fees from Sec. ~4 <br /> A2. Add5% suraharge (.05 xA1) <br /> <br />Subtotal <br /> <br />B. Enter 25% of line A 1 for Plan Review <br /> (Al + .25), if required <br />C. lnvesilgafion l%e (if required) <br /> <br />Receipt No.~ <br /> <br /> <br />