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"MAPRO N COUNTY <br />BUILDING INSPECTION <br /> 220 High aL NE ' <br /> Salem, Oregon 97301 <br /> Ph: 588-5147 <br /> MECHANICAL PERMIT <br /> <br /> ( ) Will call for inspection <br /> <br />RLDG. PERMIT NO: <br /> <br />MECH, PERMIT NO: <br /> <br />Typeof Permit: ~~ <br />Address; <br /> <br />Owner: <br /> <br />Installer: <br /> <br />Application is made for: <br /> <br />Appliance <br /> <br />Make <br /> <br />BTU input Floor area <br />Vent Size Fuel __ <br /> <br />COMMENTS: <br /> <br />DATE: <br /> <br /> Phone: Address: <br /> <br />( ( ) Replacement <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 BTU , 7,50 <br /> Floor Furnace 6.00 <br /> Suspended Heater 6,00 <br /> Wall Heater 6;00 <br /> Floor Mounted Unit Heater, 6,00 <br /> Heat Pump 6.00 <br /> Ai~ ~nd!ing Unit to 10,000 cu. ft. 4.50 <br /> Air Handring Unit ova,r,10.000 gu. ft. 7.50 <br /> Evaporative Cooler 4.50 <br /> Exhaust SyStem Commercial 4.50 <br /> Hood and Exhaust Commercial 4.50 <br /> Domestic Range Hoods 4,50 <br /> Domestic Exhaust Fans & Dryer Vents 3,00 <br /> Dom,~s!lc Wood Stove 7.50 MOP'C) <br /> Commerciar or Industrial Incinerator 30,00 <br />Fire Damper 3,00 <br />G,.a~ ,,.wa.!,e r Heater 7.:5.(~, <br />Gas Connection w/o Appliance (174 each) 2.00 <br />Over 4- $8.00 plus aa, addnl. ,50 <br />Appliance or accessory to any"~'~iirlg o'r <br />....... Corn,fort cooling system not covered 4.50 <br />Other (as per,,,k, lechan[cal Co~e): <br /> FEE <br />Please return COMPLETE APPLICATION <br />with the indicated fee, PLAN REVIEW FEE $ <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 snd 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 contr¢~ctor, <br />( ) I am performing work on a property I own or occupy, <br />( ) Other (please spec~F'F%----~ / ~, <br />SIGN AT U R E O F A P P L ICA N 3~<~'~¢¢¢" .~./~'¢~¢,,~ BLDRS BOARD REGISTRATiON # ,~<~-~ / <br /> <br /> <br />