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Mechanical Permit Application <br />Appl. Recd; <br /> <br /> MARION COUNTY Mechanical Permit Application <br /> DEPT. OF BUILDING INSPECTION <br /> Senator Building # 225 410 <br /> 220 High St., N.E. 2nd Floor Bldg. Permit No ...... <br /> Salem, Oregon 97301 <br /> R.H. WlTHROW, BLDG. ADMINISTRATOR Mechanical Permit NO. 410 <br /> 588-5147 -- 588-5148 <br />5:00 P.M.- .........CODE-A-Phone 588-5373 ............ .8:00 A.M, Date: 4/7/83 <br /> <br /> .Tax Lot No: <br /> <br />City of Del;~coit Sec. Twnshp. Rge. <br />g.5-~ ~/ Address: /.~Z:~ ~/;'~Ze.~'~; J~ <br /> <br />Bldr. & No.: Phone: Address: <br />Plans by; Phone: Address: <br /> <br /> [] New Installation <br />Application is made for: [] Addition <br /> <br /> Appliance <br /> Make m~.,e,~ ~./ <br /> <br /> / <br /> BTU Input Floor Area <br /> Vent Size. Fuel <br /> <br />Comments: Jc~o~' J~/a~/'/~" <br /> <br />Approved By: <br />Date: <br /> <br />[] Replacement <br />[] Gas Connection <br /> <br />iTEM NO, FEE AMOUN1 <br />FOr Issuance of Permit 10.00 <br />N.e.W Install. Ls 1000,000 BTU .... 6.00 <br />Replac~..m.~nt LS 100,000 BTU ...... 6.00 <br />New Install. More 100 000 B'[~. ... 7.50 <br />Replacement. Mo.[~..lOO,OOO BTU 6.00 <br />New Install. Floor Furnace 6.00 <br />Replacement Floor Furnace 6.00 <br />New Install. Su~p~n_ded Heater 6.00 <br />Repl~.c.~ent Suspended Heater 6.00 <br />New Install. Wall Heater 6.00 <br />Replacement Wall Heater 6.00 <br />New Floor Mounted Unit Heater 6.00 <br />Replace .FIop.r .~ounted Unit Heater 6.00 <br />Boiler/Compr. 3hp, 100,000 BTU 6.00 <br />Boiler/Compr...l..~...h.l~, 500,000 BTU 11.00 <br />.... Boiler/Compr. 30 bp, 1,000,000 BTU 15.00 <br />Boiler/Compr. 50 hp~.~..~750,000 BTU 22.50 <br />BOiller/C~mp~:.o..¥er 50 hp, 1,750,000 BTU 3750 <br />Air Handl.ing Unit to 10~000 cu. !!.. ........ 4.50 <br />Air Handling Uni~..?~[ 10,000 cu. ft. 7.50 <br />.... Evaporative Cooler 4.50 <br />Exhaust Syst em lC~m,m,.,~rcial 4.50 <br />Hood and Exhaust Commercial 4.50 <br />Domestic Type In, cln,er~,.O~,,~ Wood Stoves 7.50 ~7~ <br />Commercial or Industrial Incinerator 30.00 <br />Gas Connection Without Appliance (1 to 4 each) 2.00 <br /> Over 4- ~ii00 Plus Each Additional l 50 <br /> Appliance ~)r Accessory to An Heatin or <br /> Comfort COOlin~l si/stem Not ~Yovered,~gbove 4.50 <br /> <br />I agree to instal/according to the submitted plans and specifications, the laws of the State of Oregon and the Ordinances of <br />Marion County. Permit expires if work not commenced within 120 days. I further expressly warrant that I comply with the prow- <br />sions of ORS 701.005 to 701.125 because: <br />( ) I am a registered contractor or ( ) the authorized representative of a registered contractor. <br />(V~ The work will be performed by a registered contractor. <br />( ) I am performing work on a property I own or occupy <br />( ) Other (p/ease specify) <br /> <br />SIGNATURE OF APPLICANT: <br /> <br /> <br />