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omcE <br />,-IReee~ved b~'-'3/~ I <br /> <br />MECHANICAL PERMIT APPLICATION <br />Please complete all Sections, 1 through 5 <br /> <br />MARION COUNTY BUILDING INSPECT.,EON~ ~ <br /> <br /> Salem, oregon 97301 [Jg /~ ....... ' <br /> k./dU~ <br /> 0 <br /> l~hone 58S-5147 S:00 a.m, ~ 4:30 p,m. SITE #: <br /> Code-A-Phone: 58S-7904 <br /> I FAX: 58S-7948 Date: MARION <br /> I:IU ILIUII~L~ <br /> Issued by: <br /> <br />1. LOCATION O~: INSTALLATION <br /> <br />JobAddre,s '~t~) ~ - <br /> <br />PERMITS ARE NON-TRANSFeRABLE AND NON.REFUNDABL~ AND <br />]~XPIR~ IF wo P,,K IS NOT STARTED ~flTHR¢ IS0 DAYS OF ISSUANC, E <br />ORIP WORK I$ SUSPENDED FOR lS0 DAYS. <br /> <br />2A. CONTRACTOR iNSTALLATION ONLY <br /> <br />Board R¢~;, ~o, I Sob No, <br /> <br /> 2B. FOR OWNER INSTALLATIONS <br />I'rope~y Owner <br /> <br />Mailing Add.ss <br /> <br />~ity/Sk~e/Zip <br /> <br />Th~ installation is b~inS made on property I own which is not intended for sale, <br /> <br />Ownor's Signature <br /> <br /> S, PLAN REVIEW SECTION <br /> <br /> RtiSIDENTIAL [~ COMMERCIAL [] <br /> <br /> NO. x FEE - SUM <br />BASE ~E $10,00 <br /> <br /> Forced Ak Fttmace $ 6.00 <br /> I00,000 BTU or less <br /> Over 100,000 BTU -- $ 7.50 <br /> <br />Floor Fumaoe __ $ 6.00 <br />Susl~lded I-Ieate~ __ 5 6.00 <br />Wall Heater __ $ 6.00 <br />~oor Mounted Unit Heater __ $ 6.00 <br /> <br />Heat 'Pump or Air Conditioner <br />Up to 3 Ton -- 5 6.00 <br />3 Ton to 15 Ton 511.00 <br />Evaporative Cooler -- $ 4.50 <br />Exhaust System, Commercial __ 5 4.50 <br />Hood end Exhaust, Comanemial __ 5 4.50 <br /> <br />Domestic Range Rood __ $ 4.50 <br />Domestic Exhaust Fans <br />end Dryer Vents __ $ 3.00 <br />Fire Damper <br /> ¢dgd:,54 s3.00 <br /> $ 7.50 <br />Furnace Dvms (Alteration, Extension) __ $ 7.50 <br />Commercial or Industrial Incinerator __ 530.00 <br /> <br />Gas Water Heater (relocation <br />orreplacemont) __ $ 7.50 <br />Gas Connection w/o Applienea <br />--per outlet, up to 4 __ 5 2.00 <br />-~over 4, 58.00 plus ea. <br />additional $ .50 <br /> <br />For the Installation, Relocation <br /> er Replac~ent of ea. Applience <br /> Vent not included men <br /> Appliauce permit. <br /> <br />Other (as required by Building Omcial) <br /> <br />__ $ 3.00 <br /> <br />We will provide plan review service if you Complete Section <br />5B and submit two (2) sets of plans and specifications with <br />this application. <br /> <br />This optional plan review program does not suspend the <br />required submission of plans, and specifications when req~red <br />by the Oregon Structural Specialty Code, Chapter 53. <br /> <br />~C' 1 J~41 <br />,Rev, 2/92 <br /> <br />5. FEES <br /> <br /> <br />