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Permit - 1267771
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Permit - 1267771
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Last modified
6/9/2011 8:50:55 AM
Creation date
9/2/2003 3:21:43 PM
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Template:
Permits
Permit Address
1005 CHURCH ST
Permit City
Aumsville
Parcel Number
082W25DC01600
Permit Type
Permit
Permit Site Number
5246
Permit Doc Type
Permit Document
Status
Ready to Film
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Mechanical Permit Application <br /> <br />Appl. Recd: <br /> <br />By: <br />Date/ <br /> <br /> MARION COUNTY <br /> DEPT. OF BUILDING INSPECTION <br /> Senator Building # 225 <br /> 220 High St., N.E. 2nd Floor <br /> Salem, Oregon 97301 <br />R.H. WlTHROW, BLDG, ADMINISTRATOR <br />588-5147 -- 588-5148 <br />5:00 P.M.- ........... CODE-A-Phone 568-5373 ............. 6:00 A;M. <br /> <br />Mechanical Permit Application <br /> <br /> Bldg, Permit No.. <br /> <br />Mechanical Permit No. 526 <br /> 17~o/s4 <br /> Date: Dottle <br /> <br />Type of Permit: <br /> <br />Bldr. & Ne.: <br /> <br />Plans by: <br /> <br />CITY OF AUMSVILLE <br /> <br />Phone: Address:.. <br />Phone: Address: <br /> <br />Tax Lot NO: <br />Sec. Twnshp <br /> <br />Rge. . <br /> <br /> [~/New Installation <br />Application is made for: [] Addition <br /> <br /> Appliance <br /> Make <br /> BTU Input, Floor Area~ <br /> Vent Size Fuel <br /> <br />Comments:, · <br /> <br />Approved By: <br />Date: <br /> <br />[] Replacement <br /> [] Gas Connection <br /> <br /> ITEM 1 NO, FEE ' AMOUNT <br /> For Issuance of Permit 10'.00 <br />. New Install. Ls 1000,000 I~TU 6.00 <br />.. Replacement LS 10.0,000 BTU 6.00 <br />New Install. More 100,000 BTU 7.50 <br />Replacement More 100,000 BTU 6.00 <br />New Install. Floor Furnace 6.00 <br />Replacement Floor Furnace 6.00 <br />New Install. Suspended Heater 6.00 <br />Rep acement Suspende_d., ~leat~r , 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,?loor Mounted Unit Heater 6,00 <br />Soiler/Compr. 3 hp, 100,000 BTU ' 6,00 <br />BoJler/Compr. ..... 15 bp, 500,000 BTU 11.00 <br /> BoilerfCompr. 30 hp, 1.00.0,000 BTU ' 15.00 <br /> Boiler/ComDr. 50 hp, 1,750,000 BTU .22,50 <br /> Boiler/ComDr.,over 50 hp 1 750 000 BTU 37 50~, <br /> Air Handling Unit to 10,000 cu, ft. 4.50, <br /> Air Handling Unit over :10 000 cuft 7,50 <br /> Evaporative Cooler ' ~. 4.50 · <br /> Exhaust SYstem Commercial ...... "~" ' 4.50 <br />Hood and Exhaust Commercial ".. ' 4.50 <br />Domestic.,, Type Incinerator & Wood Stoves ' 7,50 ..' <br />.... ,C. ommercial or'Industrial Incinerator '30.00 <br />Gas Connection Without Appliance (1 to 4 each) 2.00" <br />Appliance or Accessory to An Heating or <br /> Comfort Cooling System Not ~Yovered Above 4,50 <br /> <br /> FEE <br /> ,~, ~'< 4:~,~.....~:~/..-~ SURCHARG, <br /> <br /> I agree to install according to the submitted plans and specifications, the laws of the State of or~g.~:~;~nd the Ordinance~ of <br /> Marion County. Permit expires if work not commenced within 120 days. I further expressly warrant tbe~:~.comply w/th the provi- <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 />(2 The work wig be performed by a regictered contractor. :: <br /> I am performing work 'on a property / own or occupy <br /> ( ) Other (please ~pecify) ~ ~ <br /> SIGNATURE OF APPLICANT~ /~ <br /> <br /> <br />
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