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IPLUMBING PERMIT APPLICATION <br />Please complete all Sections, I through 5 <br /> <br />1. LOCATION OF n~ISTALLATION <br /> <br />COMMUNITY DEVELOPMENT CENTER ~J~ ~,,~. '"~[lll <br /> 285 Church St NE ' Room 132 q~aj~m., .~. <br /> '"' JUN 1 3 1997 <br /> Date: <br /> <br /> ' 24 hr. Inspection Line 3734427 MARION COUNTY <br /> Office: Phone $88-5147 8:00am - 4:30pm ISS~.~C.,~,ll~'°l~o'rlt~M~-v. ,v,, <br /> <br />PERMITS ARE NON-TRANSFERABLE AND EXPIRE IF WORK IS NOT <br /> STARTED WITHIN IS0 D^¥$ OF IS SUA~C'E on IF <br /> WORK IS SUSPF. NDED FOR IS0 D^YS. <br /> <br />2A. CONTRACTOR INSTALLATION ONLY <br /> <br />IviailingAddreas ~.~), ~ \\~) tt~JtU~ <br /> <br />Plumbing Board: <br /> <br />Mailing Addre~ J Phone <br /> <br />City/State4Zip <br /> <br />Owner's Signature: <br /> <br />Agent's Signature: <br /> <br />4; FEE SCHEDULE (Complete and cat~ total in A I below) <br /> <br /> RESIDENTIAL I2 COMMERCIAL ~:~ <br /> USE OF ~UC~: ~ <br /> NEW ~ AL~TIO~DD~ION ~ ~OCATION ~ <br /> N~ X P~ = ~m <br />B~E FEE $~.~ <br /> <br />RESIDENTIAL (each f'~tturO <br /> Aurora Dwelling Plumbing Fee __.sq. ff. x $.070 = <br /> <br />Single Family or multi-family per <br />dwelling unit <br />New consa'uction $ I0.00 <br />AIt~ratio~ St0.00 <br />Reconnect $ 5.00 -- <br />Relocated Structure $ 5.00 <br />Modular Structure $ 5.00 -- <br /> <br /> First 100 R. or fraction Ihereof <br /> For ea. addnl' 100 ft. (up Io <br /> maximum of 500 fl.) <br /> <br />Sanitary & Storm Lines <br /> First 100 ft. or fraction thereof <br /> For addal' 100 ft. (up to <br /> maximum of $00 ft.) <br /> <br />COMMBRCIAL (each f'oaure) <br /> New construction <br /> <br />$20.00 <br />$1.5.00 <br /> <br />$30.00 -- <br />$15.00 <br /> <br />$10.00 <br /> <br />$15.00 <br /> <br />$30.00 <br /> <br />$15.00 <br /> <br />Water Lines <br /> Fimt 100 ft. or fraction thereof <br /> For ca. addnl' 100 ft. <br /> <br />Sanitary & Storm Lines <br /> Fimt 100 fl. or fraction thereof <br /> For addnl' I00 ft. <br /> <br />PROTECTIVE BACKFLOW DEVICE <br /> Lawn vacuum breaker (sprinkler sys~rn) . <br /> All others <br /> <br />$4.50 4,~0 <br />$10.00 <br /> <br />OTHER (as requitedby OSPSC <br /> and Budding Ol~ciaO <br /> <br />DWELLING PERMIT LABEL # of Labels N/C <br /> <br />3. PLANR~VIBW SECTION <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 />Al. Enter total of fees from Sec. #4 <br />A2. Add 5% surcharge (.05 x At) <br /> Subtotal $...~s~.~ <br /> <br />B.Emer25%oflineAl for Plan R~view <br /> (Al + .25), if r~qui~d <br /> <br />D. Rcimp~ction Fee ($25.00) $ <br /> <br /> <br />