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Mechanical Permit Application
<br />Appl. Recd:
<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 588-5373 ............ 8:00 A.M.
<br />
<br /> Mechanical Permit Application
<br />
<br /> Bldg, Permit NO.,
<br />
<br />Mechanical Permit No~
<br /> Date:
<br />
<br />Type of Permit: wood stove in house
<br />Address: 6003 Shaw Highway, S'.
<br />
<br />Owner: 1'{;¢. G~ca~t: ...... Phone:
<br />Bldr. & No.:. Phone:
<br />Plans by: Phone:
<br />
<br />Address:
<br />Addreas~
<br />Address:
<br />
<br />Tax Lot No:.
<br />
<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 />[] Replacement
<br />[] Gas Connection
<br />
<br /> ITEM NO. FEE AMOUNTI
<br /> For issuance of Permit 10.00
<br /> New install. La 1000,000 BTU 600
<br /> Replacement Ls 100,000 B'~[,I ........ 6.00
<br /> New Install. More 100,000 BTU 7,,50
<br /> Replacemen.~...More 100,000 BTU 6.00.
<br /> New install. Floor Furnace 6.00
<br /> Replacement .F.Ioor Furnace 6.00 ......
<br /> I~,w,,!,~.stall, Suspended Heater 6,00
<br /> Replacement Suspended Heater 6,00
<br /> New Install, Wall Heater 600
<br />..Replacement Wall Heater 6.00
<br />New Floor Mounted Unit Heater 6.00
<br />Replace Floor Mounted Unit Heater 6.00
<br />BoilerlCompr. 3 hp, 100,000 BTU 6.00
<br />Boller/Compr. 15 hp, 500,000 BTU 11
<br />... Boiler/Compr. 30 hp, 1,000,000 BTU 15.o0
<br />BoilerlCompr. 50 hP, 1,750,000 BTU 2250 .............
<br />Boiler/Compr. over 50 bp, 1,750,000 BTU 37.50
<br />Air Handling }.Init to 10,000 cu. ft. 4.50
<br />Air Handling Unit over 10,000 cu. ft. 750
<br /> Evaporative Cooler 4.50
<br /> ExhaUSt System Commercial 4.50
<br /> Hood and Exhaust Commercial 4.50
<br /> porne~!q Type,l~oinerator & Wood Stoves 7.50 7.50
<br /> Commercial or Industrial Incinerator 30.00
<br /> Gas Connection Without Appliance (1 to 4 each) 2,00
<br /> Over4-,~,00 Plus Eaoh,~,dd,lt Ional .....
<br />
<br />Approved By: SURCHARGE $ .70 ......
<br />Oate: //// -~ ---.--~-' , 19 TOTAL $ :I_8.20 ,,.
<br />
<br />I agree to install according to the submitted plans and specifications, the laws of the State of Oregon and the Ordinances of
<br />Marion County.. Permit expires if work not commenced within 120 days. I further expressly warrant that I comply with the prow.
<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 />( ) The work will be performed by a registered contractor
<br />( ) I am performing work on a p~erty I owner occupy /
<br />( ) Other(pleasespeclfy) ]~~ ~
<br />SIGNATURE OF APPLICANT:
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