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FOR CITY VALIDATION <br />R~fivcd by:. <br />])ate: <br /> <br />~MARION COUNTY <br /> <br /> 3150 LANCASTER DR NE ' SUITE C <br /> SALEM OREGON 97305-1398 I ': <br /> Date: <br /> <br /> 24 hr. Inspection Line 373-4427 <br /> Office: Phone 588-5147 8:00am - 4:30pm [$$uod by: <br /> FAX: 588-7948 <br /> <br />PLUMBING PERMIT APPLICATION <br />P/ease complete all Sections, I through <br /> <br />1. LOCATION OF INSTALLATION <br /> <br />PI~IITS ARE NON-TRANSFERABL~ AND F_XPIRE IF WORK IS NOT ] <br /> STARTED wnTm~ 18o DAYS OF ISSUANC~ OR IF <br /> WORK IS SUSPF.~ND~ FOR 180 DAYS. <br /> <br />2A. CONTRACTOR ]~TSTALLATION ONLY <br /> <br />2B. FOR. OWNER ]~ISTALLATIONS <br /> <br />Pro~Owa~r(ple~s~prim) <br /> <br />Mailing Address ] Phone <br /> <br />· Agent's <br /> <br />3. PLAN1LEVI]~r 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 I.$-45 <br />Rev, 1196 <br /> <br />4, 1~[~]~ SC~l HuUI~ (Complet~ and entex ~okal in A I below) <br /> <br /> RE~I~ENT~A~ COMMHRCIAL <br /> USE OF ~UC~:' <br /> N~ ~ AL~ON ~ ~D~ION ~ ~CATION <br /> <br />BASE FEE <br /> <br />RES[DEN'rIAL (each fixture) <br /> Aurora Dwelling phunbing Fee <br /> <br />Single Family or multi-family per <br />dwelling unit <br /> New consLmcfion <br /> <br />No. X Fee ~$~0~ <br /> <br />__.sq. fi. x $.070 = <br /> <br />$10.00 -- <br />$10.00 <br /> <br />$ 5.00 <br />$ 5.00 <br /> <br />maximum of 500 fl-) $15.00 __ <br />mnximum of 500 fl.) $15.00 -- <br /> <br />Water Lines <br /> First lO0 fc~or frnction thereof <br /> For ea. addnl' 1(30 1~ <br /> <br />$25.00 <br /> <br />$15.00 -- <br /> <br />Sanita~- & Storm L~nes <br />First 100 fr. or fraction thereof $30.00 -- <br />For addnl' 100 fi. <br /> $15.00 -- <br /> <br />$4.50 -- <br />$ I0.00 -- <br /> <br />OTHER (sst~quitedbyOSPSC <br /> sad Buildlt~g Ol~cisO <br /> <br />DWELLINO PI[RMIT LABEL <br /> <br />Al. lqater total of f~ from Sec. #4 <br />A2. Add 5% s~rcba~e (.05 x Al.) <br /> <br />Subt,~al <br /> <br />B. Eater25% of lineAl forPlan Review <br />(Al + .25), if mquire, d $ __ <br />C. Inveatigation Fe~ (if required) $__ <br />D. Reiasp~ctinn Fc~ ($25.00) $ __ <br /> <br /> TOTAL AMOUNT DU~ <br />Receipt No. <br /> <br /> <br />