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ARION C~UNTY <br /> 1~'?' BUILDING INSPECTION <br /> 220 High ~t. NE ' <br /> <br />I~S~[C~I~ECHANICAL PERMIT <br /> <br />Installer: <br /> <br /> ( ) Will call for inspection <br /> <br />BLDG, PERMIT NO: ~k <br /> <br />COMMENTS: <br /> <br />Application is made for: <br /> <br />Appliance <br />Make ~ <br />BTU input Floor area _ <br />Vent Oize Fuel <br /> <br />Phone: Address: <br /> <br />(--,/4.) -Ne6,-h,m~ ( ) Replacement ,4,J¢C, <br />( ) Addition ( ) Gas Connection <br /> <br /> NO. FEE AMOUNT <br />Base Price 10.00 <br />Forced air furnace 100,000 BTU or less 6,00 <br />Forced air furnace over 100,000 B.T.U 7,50 <br />Floor Furnace 6.00 <br />, S.,u_s. pended Heater 6,:,(~0 <br />Wall Heater 6,00 <br />Floor Mounted Unit Heater 6,00 <br />Heat 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 />Hood and Exhaust Commercial 4,50 <br />?,omestic Rankle Hoods 4.50 <br />Domestic Exhaust Fans & Dryer Vents 3.00 <br />Domestic Wood Stove 7,50 <br />Commercial or Industrial Incinerator 30,00 <br />Fire Damper 3.00 <br />Gas Water Heater 7.50 <br />Gas Connection w/o Appliance (1-4 each) 2,00: <br />over 4- $8.00 plus-es;' sddnl. .50 <br />Appliance or accessory to any heating or <br />Comfort cooling system not covered 4.50 <br />Other (a§ per Mechanical Code): <br /> FEE <br />Please return COMPLETE APPLICATION ~.-'~ ~ ~ <br />with the indicated fee. PLAN REVIEW F'~¢ <br />INVESTIGATION FEE $ <br />FLEET SURCHARGE <br />TOTAL <br /> <br />I agree to install 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 furtherwarrant <br />that I comply with the provisions of ORS 701.005 to 701,125 because; <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 />( ) Ct he r ( please specify).,~ <br />SIGNATURE OF APPLICANT: ¢¢2~¢¢~' BLDRS BOARD REGISTRATION # <br /> <br />.... ·/-'"Address: <br /> <br /> <br />