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IFOR'CIT~ VALIDATION <br /> <br /> Received By: <br /> <br /> Date: <br /> <br /> MARION COUNTY <br />BUILDING INSPEC-rlON DMSION <br />3150 Lancaster Dr. NE - Suit~ C <br /> Salem, Oregon 97305-1398 <br /> <br /> 24 HR lasp~etion Line 373-4427 <br />Office: phone 588~$147 8:00am - 4:30pm <br />FAX ~7948 <br /> <br /> PLUMBING PERMIT APPLICATION <br />Please complete all Sections, I through 5 <br /> <br />· LOCATION OF INSTALLATION <br /> <br /> C <br /> <br /> /7 <br /> <br />PERMITS ARE NON-TRANSFERABLE AND EXPIRE IF WORK IS NOT <br />STARTED WITH~ 180 DAYS OF ISSUANCE OR IF <br /> WORK IS SUSPENDED FOR 180 DAYS. <br /> <br />2A. CONTRACTOR INSTALLATION ONLY <br /> <br />Contractor <br /> <br />2B. FOR OWNER INSTALLATIONS <br /> <br /> Agent's Signature <br /> <br />3. PLAN REVIEW SECTION <br /> <br />IMarion 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 al~plieation. <br /> <br />PERMIT NO: <br />Date: <br /> <br />Issuedby: <br /> <br />4. FEE SCHEDULE (Complet~ and ~mm' total in 5-Al below) <br /> <br />~IDENTIAL ~ CO~ERC~L ~ USE: <br /> NEW ~ ~ON ~ ~D~OH ~ ~L~A~ON ~ <br /> <br />BASE FEE A~s~d on ~1 ~pli~ ~0.~ <br /> (Exception: W~/Sew~ Li~ A~li~ w~ ~) <br /> <br />~A D~ ~R~R <br />BAC~W P~V DEVICE LARRY ~ <br />BA~ ~R <br />BIDET SHO~R <br />CATCH BAS~ S~ ~ <br />C~S W~R ~OU~ D~ ~ <br />D~ ~IT ~HO~R <br />CUSP~R ~ <br />D~G FO~ WA~R C~SET ~ <br />~OOR D~ WA~ ~A~R ~ <br />O~R ~ B~ <br /> <br />To~al # Fixtures <br /> <br />x $10.00 =$ <br />x $4.50 =$ <br /> <br />Lawn vacuum b~akcr / sprinkler system <br /> <br /> Residential: First 100 R., Or fracfion thereof -- x$20.00 =$ <br /> For ca addnl 100 fi Up to ~00 feet <br /> Commercial: First 100 fl. Or fi'action thereof -- x $25.00 <br /> Forcaaddnl lOOf~q -- x$15.00 <br /> <br /> Residential: Firstl00fi. Or fra~io~ thereof -- x$30.00 <br /> For ca addn1100 t~ Up to 500 fee~ -- x $15.00 <br /> Commercial: First 100fi. Or fraction thereof -- x$30.00 <br /> For ca addn1100 feet -- x$15.00 =$__ <br /> <br /> Residential: First 100fi. Orfractionlho~of -- x$30.00 <br /> <br />(Pack of 10 labels ~ $5.00 each, ~old oaly to Pkm~bing con~lors) <br />~ # of Labels N/C <br />(For New Single Family Dwellings Only) <br /> <br />5. FEES <br />A I. Enter tool of fees from S~. #4 $ <br />A2. Add 5% surcharge (.05 x Al ) $ <br /> Subtotal $ <br /> <br />, B. Enter 25% ofllne Al for plan Review <br /> <br /> (Al + .25), if required <br /> C, Investigation Fee (if t~qulred) <br /> D. Relnspection Fee ($25.00) <br /> <br />Receipl No. __ <br /> <br />TOTAL AMOUNT DUE <br /> <br />MC 15-45 7/97 <br /> <br /> <br />