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Marion County Building Inspection <br />5155 Silverton Rd NE - PO Box 14500 - Salem, Oregon 97309 <br />Phone: (503)588-5147 Inspection Line: (503)373-4427 <br />Check your Permit Status On Line at: http://publicworks.co.marion.or.us/building/ <br />PLUMBING PERMIT <br />DATE: 07-15-2011 TYPE: PLBG PERMIT NO: 10-04499 <br />OFFICE: MC USE: R STATUS: FINAL <br />CONST: MAP: ISSUED: 08/31/2010 <br /> SITE: TO EXPIRE: 06/22/2011 <br /> ZONE: AR <br />____________________________________________________________________________________________________________ <br />WORK DESC: 300 FT WATER LINE MFG 10-04500 <br />SITE ADDRESS: 4622 BROOKS LN SE TR <br />PARCEL: 092W20B 01004 <br />APPLICANT: BROOKS KAREN <br /> ADDRESS: P O BOX 796 <br /> TURNER OR 97392 <br /> PHONE: <br />PARCEL OWNER: BROOKS KAREN <br /> ADDRESS: P O BOX 796 <br /> TURNER OR 97392 <br /> PHONE: <br /> OCCUPANT: <br />CONTRACTOR: PALM HARBOR HOMES INC <br /> OCCB: 0129552 <br /> PHONE: 972-9912422 FAX: <br />PLUMBER: <br /> LICENSE: <br /> PHONE: <br />LANDSCAPER: <br /> LICENSE: <br /> PHONE: <br />___________________________________________________________________________________________________________ <br />Units DescriptionFeeDescriptionFee <br /> 0 New Plumbing Fixture $0.00 Refund $0.00 <br /> 0 Res. Re-pipping $0.00 <br /> 0 Res. Fire Suppression 13D $0.00 Subtotal Fee Items <br /> $93.00 <br /> 300 Water Lines $93.00 <br /> 0 Sanitary Sewer Lines $0.00 Subtotal items less than $67.25 <br /> 0 Storm Drains $0.00 Min Plumbing Permit fee assessed. <br /> 0 Lawn Vacuum Breakers $0.00 <br /> 0 Other Backflow Devices $0.00 Min Plumbing Permit Fee <br /> $93.00 <br />Com. Medical Gas Install $0.00 State Surcharge <br /> $11.16 <br />Plan Review $0.00 <br /> 0 Additional Plan Review Hrs $0.00 Total Fees: <br /> $104.16 <br />Investigation Fee $0.00 Total Payments: <br /> $104.16 <br />Other Plumbing Fee $0.00 Balance Due: <br /> $0.00 <br />SFD (1) Bath $0.00 <br />SFD (2) Bath $0.00 <br />SFD (3) Bath $0.00 <br /> 0 SFD Additional Bath $0.00 <br />___________________________________________________________________________________________________________ <br />THIS PERMIT EXPIRES 180 DAYS FROM ISSUE DATE IF WORK HAS NOT COMMENCED, OR IF CONSTRUCTION CEASES FOR A PERIOD <br />OF 180 DAYS, OR IF WORK FAILS TO MEET ALL REQUIREMENTS OF STATE LAWS AND MARION COUNTY ORDINANCES. UPON WRITTEN <br />REQUEST, SIX MONTH EXTENSION MAY BE GRANTED. <br />SIGNATURE OF APPLICANT:_________________________________________________________________ <br />_____________________________________________________________________________________________________________________________ <br />WARREN D. JACKSON, MARION COUNTY BUILDING OFFICIAL / BY CLYNCH <br />_____________________________________________________________________________________________________________________________ <br />CALL BEFORE YOU DIG...IT'S THE LAW. <br />ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth by Oregon Administrative Rules. You may obtain copies <br />of the rules by calling the center. <br />(Note: The telephone number for the Oregon Utility Notification Center is 1-800-332-2344). <br />