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Received Sy; <br />Date; <br /> <br />MARION COUNTY BU LD NG INSPECTION <br /> <br /> 22{) High Street NE <br /> Salem, Oregon $7501 <br /> <br /> Phone 588-5147 <br /> Code,A-Phone 4:30 P.M. - 8:00 A,M. <br /> <br />PLUMBING PERMIT APPLICATION <br /> <br />Owner: Phone: Mailing ~,ddress: ..... <br />Job Ad~lress: '" Site No. Cross Street: ..... <br />P[umblng Instal[er: ..... Phone: Add~ese: ..... <br />, Sudson's, Inc. 363-4141 P.O. Box 12669 Dslrm, OR 97309 <br />Home Sullder's Reg~strat on No <br />' 34604 <br />Residential; [~" New:' ~" AdditiOn: [] Occupancy Use of Building: <br />Comm&rcial; ~q Alteration; [] Relocation; r~ Change: [] <br /> <br /> ' . ''o, FEE AMOUNT <br /> Base Price ~ $20.00 <br /> Residential ..... <br /> New construction each fixture ....., . , ~ $ 9,00 . <br /> A~terations (each fixture) 9,00 <br /> Re-located Res dance (each f xture ' ' 4,50 <br /> Commercial .... <br /> New Construction (each fixture) . 9,00 <br /> Alterations each f xture) . 9.00 <br /> <br /> Water Lines , ' <br /> F?r the firet.100 feet ~r fraction thereof '' 20,00 .... <br /> For addltlona1100 feet 15.00 <br /> Sewer Service Lines ' ' <br /> First 100 feet er fraction there, of 30.00 <br /> Additional 100 feet 15,00 <br /> Mobile Home sewer/water connection <br /> (maximum 5 feet I~ngth) · " 25.00 <br /> Other (as per OSPSC and Building Official) " <br /> OnrSite Techn ca Rev ew (apply at Marion County only) <br /> Re-Inspection Fee , ~ ~ , 25.00 <br /> STATE SURCHARGE ~'~ <br /> PLAN REVIEW FEE $ <br /> INVESTIGATION FEE $ <br />Please return COMPLETE APPLICATION FLEET SURCHARGE $ <br />with the indicated fee. C~TY FEE <br /> <br />I am a registered builder OR ('11( the authorized rooreaentative ct SIGNATURE OF APPLICANT <br />a registered builder. <br />The work will Se oerformed by a re~ atemd bull0er. <br />Other , <br /> <br />MC 15.45 <br />Rev. 12/87 <br /> <br /> <br />