PLBG - 1484017 - Laserfiche WebLink

Home Browse Search

MARION COUNTY BUILDING INSPECTION COMMUNITY DEVELOPMENT CENTER PERMIT NO: 285 Church St NE ° Room 132 FOR CITY VALIDATION Salem, OR 97301 [Date:__ ] 24 Issued byl Orate: ~'~MBING PERMIT A PPLICA~O---~'~ ~Cm~b'U~ (Co,.[,leta ..d e.t~total ~AI baow) LPlease complete ail ,gections, I through 5 J ~J~ ?~t0N COU~.~R~BNTIAL D COMMBRClAL 1. LOCATION OF m~FALLATION B JlU NEW El ALTERATION D ADDITION ~ RELOCATION lob Addrcss No. X Fee BASE FEE RESIDIgHTIAL (each fixture) Aurora Dwelling Plumbing Fee sq. fi. x $.070 Single Family or multi-family per New construction $10.00 Aitarations $10.00 -- I ~ Reconnect $ 5.00 -- STARTED W1THIN 1 ~0 DAYS OF ISSUANCE OR IF Modular Structure $ 5.00 -- WORK IS SUSPI~qDEI) FOR 180 DAYS. First 100 ft. or fraction thereof $20.00 2A. CONTRACTOR INffrALLATION ONLY For ea. addnl' 100 ft. (up to maximum of 500 ft.) $15.00 Sanitary & Storm Lines ~,in~ ^~., I 151~' ~ ~ o ~"" ForFh'st 1oo ft.o£ fraction thelt~ofadd[ll. I00 ft. ("p to New mnstruction $10.00 -- Alterations $10,00 Reconnect $10.00 -- Contractor's Signature: W~ter Lines $15.00 Sanitary & Storm Lines olaerint~ Fi~t 100 ft. or fraction the=of $30.00 -- sap ) Foraddnl' 100 ft. $15.00 IMa'd~ng Address Phone -- PROTECTIVE BACKFLOW DBVICE City/State/Zip Lawn vacuum breaker (sprinkler system) $ 4.50 -- All othe~ $10.00 -- Owner's Signature: OTHER (asrequiredbyOSPSC and Budding O£gciM) Agent's Signature: ~ DWELLING PERMIT LABEL # of Labels N/C 3. PLAN RBVIBW 8BCTION Marion County does not require a plan review. We will provide plan review service if you complete Section 5B and submit two (2) sets of plans and specifications with this application. MC 15-45 R0v. 1/96 5. FBBS Al. Enter total of foes from S~c, #4 A2. Add 5% surcharge (.05 x Al) Subtotal $__ B. Enter 25% of line A 1 for Plan Review (Al + .25), if required C. lnwstigaimn Fee (if required) D. Reinspection Fee ($25.00) TOTAL AMOUNT DUIB Receipt No..