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Received By; <br />Date:., <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> Senator Bldg. No. 225 <br /> 220 High Street lie <br /> Salem. Oregon 97301 <br /> Phone588~147 <br /> Code-A-Phorte 4:S0 RM, - 8:00 A.M. <br /> <br />PLUMBING PERMIT APPLICATION <br /> <br /> Phone: Mailing Address: <br /> <br /> Job Address: Site No.: Cross Street: <br /> <br /> Plumbing Installer: ~ Phone: <br /> :Judson's Inc. 363-4141 P.O. Box 12669 Sal~ OR 9730~ <br /> Home Builder% Begistrafion <br /> 34604 <br />-'~sident a ~ New: ~ Addition: ~ Occupancy Use of Building: <br />Commemjal: ~ .... Ateration: ~ Relo~ton <br /> <br /> ~ NO. FEE AMOUNT .... <br /> Base Price. , , ~ <br /> Residential <br /> Newconstruction (.eachfixture) $ 9.00 <br /> Alterations (each fixture) .... ...... 9,00 <br /> Re-located Residence (each f xlure) 4,50 <br /> Commemlal <br /> New Construction (each fixture} ' , ..... 9,00 <br /> Alterations (each fixture ,, 9.00 <br /> WaterLines ..... <br /> For the flr~ 100 feet or fraction thereof ., / 20.00 <br /> ' For addltlona1100 feet 15.00 <br /> . ,S. ewer SeWlas Lines <br /> First 100 feet or fraction, thereof , ..... / 30,00 ~,~ O~. <br /> Additional 100 feet .,/ 15.00 / <br /> Mobile H~)me sewer/water connect on <br /> (maximum 5 feet length) .. 25,00 <br /> Other (as per OSPSC and Buildir!g Official <br /> On-Site Technical Review app y at Mar on County on y <br /> Re-Inspection Fee "" , 25,00 <br /> , STATESURCHARGE %,~.:~ ~.~.. <br />PLAN REVIEW FEE $ <br />INVESTIGATION FEE $ <br />Please return COMPLETE APPLICATION FLEET SURCHARGE <br />with the indicated fee. C~TY FEE $ <br />TOTAL $ 7 <br /> <br />The work will be performed b,/a registered builder <br />ether <br /> <br />SIGNATURE OF APPLICAN~~ <br /> <br />I agree to Install a~eording to the submitted plans and specifications, the laws Of the st~((e Of Oregon and the ordinances of Ma{~on County, <br /> <br /> <br />