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/j /~ MARION COUNTY BUILDING INSPECTION <br />Recel~d ~y; ~Z~L~.~' Senetsr Bldg. NO. ~ <br /> ' - -- ~ /~ ..~ ~ 220HighSt~NE <br /> <br />J 0 b~,/~ss: Site No,: Cross Stre, et: ~,~ ,/ <br />Home Builder% Registration NO,: <br />....... <br />Residential: j,,.../ Commemial: Use~)Building,; "~/~/' <br />Naw:~ Alteration: [] Addition; [] J '%~)~-'/~/~' // <br />" ..... Relocation: [] / OccupancyChange: [] <br /> <br /> NO. FEE AMOUNT <br />Base Price 10,00 <br />.,Forced art furna~ 100,000 BTU or le~? 6.00 <br />Forced air furnace over 100,000 E~TU 7,60 <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 />_Air Handling Un!t to i0,00'0 cu. ft. 4,50 <br />Air Handling Unit over 10,000 cu. fi, 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 ~xhe:~st Fans & Dcyer Vents .~ 3.00 <br />For pm-installation or installation <br />of each wood stove 7.50 <br /> <br /> NO. FEE AMOUNT <br />Commemial or Industrial'incinerator 30.00 <br />Fire Damper 3,00 <br />Gas Water Heater 7.60 <br />For eact~'~as plp)ng system of ua'to <br />4 outlets, minimum, fee 2,00 <br />For each gas piping system of 5 or more <br />outlets, per outlet ,50 <br />Far the installation, rei~cation or <br />replacement of each appliance vent <br />not incl"ded in an appliance permit 3,00 <br />Appliance or accessory to any heatlng or I ~ I <br />Gem,!,~r t ceoling system n~ ?vered 50 <br />Other (as per M~chanical Code}: ....... <br />On-Site Technical Review <br />(App!,y at Marion Co, only) <br />Reinspestlon Fee 15.00 <br /> FEE ~'.,..~'-~ <br /> STATE SURCHARGE <br /> PLAN REVIEW <br /> INVESTIGATION FEE $ <br /> FLEET SURCHARGE $~.~ <br /> CITY FEE <br /> TOTAL <br /> <br />lam performing work on a property I cwn or occupy. ~ /~, ~//*~"2' <br />lam~mgistere~buJlderOR( )theauthorizedropresentatlveof SIGNATUREOFAPPLICANT:~ ~/~ <br />a registered builder, <br />The work will be performed ~ a registem~ builder, <br />Other ~, <br />I agreeto I~stall a~ordin9 to the submiffed plsns a~d specifications, the law~ of the sta~ of Oregon and the ordinance8 of Marlo~ Couhty. <br /> <br />MC f$-41 <br />Rev. 3/87 <br /> <br /> <br />