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· ~ ~ ~'- MARION COUNTY BUILDING INSPECTION <br /> <br />FOR CITY VALIDATION[ <br />Received by: <br />Date: <br /> <br />PLUMBING PERMIT APPLICATION <br />Please complete all Sections, I through 5 <br /> <br />1. LOCATION OF INSTALLATION <br /> <br /> 285 Church St NE · Room_~...,lr3~ <br /> <br />o <br /> <br />PERMITS ARE NON-TRANSFERABLE AND EXPIF~ IF WORK IS NOT <br />STARTED WITHIH 180 DAYS OF ISSUANCE OR IF <br /> WORK IS SUSPENDED FOR 180 DAYS. <br /> <br />2A, CONTRACTOR INSTALLATION ONLY <br /> <br />]oumeyman'sPinmbemNo. ~ 73 -DI <br /> <br />2B. FOR OWNI~ INSTALLATIONS <br /> <br />l~ope~ty Owner (pleas~ pHm) - <br /> <br />3. PLAN REVIEW 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 />Date: <br /> <br />Issued by: <br /> <br /> ('~TIl~ SCHEDULB (Complete and ~nu=r tou=I in A 1 <br /> below) <br />/blSPEGTl~swB~rrIAL"" o cot,~cI~ <br /> USB OF STRUCTURli: <br /> NEW m ALTERATION 12 ADDF~ION I/i~RELOCATION <br /> <br /> No, X Fe~ = Sum <br />BASE FP-~ $20.~0 <br /> <br />RESIDENTIAL (each fixture) <br /> Aurora Dwelling Plumbing Fee -- sq. ft. x $,065 =- <br /> <br />Single Family or multi-family per <br />dwelling unit <br />New construction $10.00 -- <br />Alterations ,.~ $10.00 <br />Reconnect $ 5.00 -- <br />ReLocated Structure $ 5.00 -- <br />ModularStruetore $ 5.00 -- <br /> <br />Water Lines <br />l;trat lO0 ft. or fraction thereof $20.00 -- <br />For ea. adgnl' 100 ft, (up to <br />maximum of 500 fl.) $15.00 -- <br /> <br /> For addnl' 100 ft. (up to <br /> maximum of 500 fl.) $15.00 -- <br /> <br /> AlU=rations $10.00 __ <br /> Reconnect $10.00 -- <br /> <br />Water Lines <br />First 100 ft, or fraction Ihereof $25.00 -- <br />For ea. addnl' 100 fL (up to <br />maximum of 500 ft.) $15.00 -- <br /> <br />OTHER (as requirod b~ OSPSC <br /> and Bui]d~g O~]ciaD <br /> <br />DWELLING PERMIT LABEL # of Labels N/C <br /> <br />.]0.00 <br /> <br />5. FEES <br /> 0 <br /> A 1. Enter total of fees from See. #4 $_ -'~.) · <br /> $ 0 <br /> A2. Add 5% s~har~ (.05 x Al) ~bt~nl $~.~,~O <br /> <br /> (Al + .25), if ~qm~ $.~ <br /> C.Investigation ~ (if ~qu~d) $.~ <br /> D.~i~peet~n Fee ($~.~) $.~ <br /> <br /> <br />