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~ > a~,y ~o~i.~p~,on MARION COUNTY <br /> <br /> Salem, Oregon 97501 <br /> <br />By, ~~ ECHANICAL PERMIT <br /> <br />Address: 285 C%evlan~ St. A~msvi%%e <br />Owner: Dennis Richards Phone: 749-26%6 <br /> <br />fCity' <br /> <br />SLDG, PERMIT NO: <br /> <br />MECH, PERMIT NO: ~ 0004 <br /> <br /> DATE; ~ <br /> <br />Installer: Phone: Address: <br /> <br />Application is made for; <br /> <br />Appliance <br />Make <br /> <br />BTU Input <br />Vent Size <br /> <br />New Installation ( ) Replacement <br />Addition (X) Gas Connection <br /> <br /> NO. FEE AMOUNT <br /> Base Price 1 10.00 <br /> Forced air furnace 100.060 BTU or less 6.00 <br /> Forced air furnace over 100,000 BTU 7,50 <br /> Floor, Furnace 6.00 <br /> Suspended Heater , 6,00 <br /> Wall Heater 6.00 <br /> Floo, r Mounted Unit Heater 6,00 <br /> Hea! Pump 6.00 <br /> Air Handling,Unit to 10.000 cu. ft, 4.50 <br /> Air Handling. Unit over 10,000 cu. ft, 7.50 <br /> Evaporative Cooler 4.50 <br /> Exhaust System Commercial 4.50 <br />Hoo. d and Exhaust Commercial 4,50 <br />Domestic Range ,Hoods 4.50 I <br />Domestic Exhaust Fans & Dry'~r ve~t~ 3.00 <br />Domestic Wood Stove ..... 7.50 I <br />Commercial or Industrial Incinerator. 30.00 <br />Fire Damper 6,00 <br />Gas Water ,Heater 7.50 <br />Gas Connection w/o Appllance (1-4 each) % 2.00 2,00 <br />over 4- $8.00 plus ea, addnl, ,50 <br />-Apppliance or accessory to any heating or <br />Comfort cooJin~ system not coYered 4.50,1 <br />Other as per Mechanical Code: <br /> FEE! $ <br />Please return COMPLETE APPLICATION 4% <br />with the indicated fee, PLAN REVIEW PE~'-E~ $ <br />INVESTIGATION FEE <br />FLEET SURCHARGE <br />TOTAL ~ <br /> <br />, Floor area <br />, Fuel __ <br /> <br />COMMENTS: <br /> <br />I agree to instat{ according to the submitted plans and specifications, the laws of the State of Oregon and the <br />Ordinances of Marion County, PERMIT EXPIRES IF WORK NOT COMMENCED WITHIN 180 DAYS, I further warrant <br />that I comply with the provisions of ORS 701.005 to 701.125 because; <br /> <br />( ) I am a registered contractor or ( ) the authorized representative of a registered contractor. <br />( } The work will be performed by a registered contractor. <br />( ) I am performing work on a property I own or occupy, <br />( ) Other (please specie__ _ <br /> <br />SIGNATURE OF APPLICANT:~,--~-~.~ ~,~ ELDRS BOARD REGISTRATION # <br /> <br /> <br />