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_ Received By:~. <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> <br />PLUMBING PERMIT APPLICATION <br /> <br />.... ' Phone: ' -~.~ Mail'~g Address: <br />JOb Address: ~Y,~ ' "//~) Site NO.: :. C~,~ <br /> PIBmbing Installer; ~ Phons: Address: <br /> Home Bui. der~ Registration NO,: , . , <br /> <br /> Re~idential: ~/ J New: ~ -- - Addition; g Oacup,noy <br /> Comme~isl: ~ , ~ Alteration: ~. Relocation: D :Change: <br /> <br /> ' NO,' FEE" ' AMOUNT <br /> Base Pric~ .. $20,00 <br /> Rasldential <br /> Newcon~ructlon(eachfixture) ' · ' $ 9.00 <br /> Alterations (each fixture) 9.Q0 ' .. <br /> - ~ated rice (e fix{u ) ' <br /> Re Io Reside ach re . .. 4.50 <br /> <br /> · New Constructioh (each fixture) . · . 9,00 · <br /> ( ach fi <br /> Alterations e xture · · - . 9,00 <br /> <br /> · Water Lines ' <br /> ....... For the first 100 feet or fraction thereof . / 20.00 , <br /> For additional 100 feet ' ' <br /> Sewer Service Lines · , <br /> First lO.g feet or fraction thereof ',/ 30,00 <br /> Additional 100 feet 15.OO <br /> Mobile Home sewsrhvater connection < ' <br /> (maximum 5 feet length) ' 25.00 <br /> _Or..,h.e.r (as per OSPSC and Building Official) <br /> On-Site Technica~ Review (aP.~[Y. at Marion,County only) , <br /> Re-inspection Fee , : · 25.00 <br /> . . BTATE SURCHARGE ,~, ~'~' <br /> i ' ,pi~AN.REViEW FEE ' $ .... <br /> <br /> INVESTIGATION FEE $ <br />Please re APPL C ' <br /> turn COMPLETE AT ON · FLEETSURCHARGE $ <br /> CITY FEE $ <br />with the indicated fee, ', TOTAL $ <br /> <br /> / <br />I~m <br /> performing work on a properly I own Or Occupy. ~¢.~_ <br />lamamgisteedbuiderOR(/~)theauthorizedreDmsentatlveo! SlGNATUREOFAPPLICAN~,,~ ~ ~- /~ /~ <br />a reglstere~ bail,e,. ~ / / '~ <br />The wO k w II be peHormed ~ a mgs er~ bu der. <br /> <br />I~gree~ nsa ecco~g o ~esubm ~ pansan~s~c eatons, thelawsof he,sate~Omgonand b~nanceao Merio~C0unty, <br /> <br />MC 15-45 <br />Rev. 12,/87 <br /> <br /> <br />