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MARION COUNTY BUILDING INSPECTION <br /> <br /> , r [~ 220 High S~eet NE <br /> , Salem, Oregon 97301 <br /> <br /> Code-A-Phone: 588-7904 <br /> <br />MECHANICAL PERMIT APPLICATION <br />Please complete all Seqtions, I through 5 <br /> <br />FAX:Sgg-794$ <br /> <br />PERMITS ARE NON-TPoVNSFERABLE AND NON-REFUNDABLE AND <br />EXPIRE IF WORK IS NOT STARTED WITHIN 180 DAYS OF ISSUANCE <br />OR IF WORK IS SUSPENDED FOR 150 DAYS. <br /> <br />2A. CONTRACTOR INSTALLATION ONLY <br /> <br /> 2B. FOR OWNER INSTALLATIONS <br />Property Owner <br /> <br />' Mailing Address Phone <br /> <br />City/State/Zip <br /> <br />Thc installation is being made on property I own whioh is not intended for <br /> <br />Owuefs Signature <br /> <br /> 3. PLAN REVIEW SECTION <br /> <br />We will provide plan review service if you complete Section <br />5B and submit two (2) sets of plans and specifications w/th <br />this application. <br /> <br />This optional plan review program does not suspend the <br />required submission of plans, and specifications when required <br />by the Oregon Structural Specialty Code, Chapter 53. <br /> <br />Rev. 2/92 <br /> <br />RECEIVED <br /> <br />SITE #: <br /> BUILDING <br />Date: <br /> <br />Issued by: <br /> <br />RESIDENTIAL [~ COMMERCIAL <br /> <br /> USE OF STRUCTUI~; <br /> <br /> NEW [] ALTF~A~0N [] ADDITION [] R~LOCATION <br /> <br /> NO, X FEE <br />BASE FEE <br /> <br />Fomed Air Furnace <br />100,000 BTU or less <br />Over 100,000 BTU <br /> <br />Floor Pumace <br />Suspended Heater <br />Walt Heater <br />Floor Mommted Unit Heater <br /> <br />l{eat Pump or Air Coaditioaer Up to 3 Ton <br /> 3 Torito 15 Ton <br />Evaporative Cooler <br />Exhaust Systm, Comm~¢ial <br />Hood and Exhaust, Commercial <br /> <br />Domestic Range Hood <br />Domestic Exhaust Fans <br />and Dryer Vents <br />Fire Damper <br />Wood Stove <br />Furnace Ducts (Alteration, Extansion) -- <br /> <br />Commercial o1' Industrial ~einerator <br /> <br />Gas Water l-l~ater (relocatioa <br /> or replacement) <br />Gas Connection w/o Appliance <br /> --per outlet, up to 4 <br /> --over 4, SS.00 plus ea. <br /> additional <br /> <br />6,00 <br />7,50 <br /> <br />6,00 <br />6.00 <br />6,00 <br />6,00 <br /> <br />For file Installation, Relocation <br /> or Replacement of ca, Appliance <br /> Vent not iucluded in an <br /> Appliance permit. <br /> <br />Other (as requi~ed by Building Official) <br /> <br />--~ $ 6.00 <br /> $11.00 <br /> $ 4.50 <br />__ $ 4.50 <br />__ $ 4.50 <br /> <br />__ $ 4.50 <br /> <br />__ $ 3,00 <br />__ $ 3,00 <br /> $ 7.50 <br />i $ 7,50 <br /> <br />__ $30,00 <br /> <br />-- $ 7,50 <br /> <br />__ $ 2,00 <br /> $ ,50 <br /> <br />__ $ 3.00 <br /> <br />SUM <br />$10.00 <br /> <br />~.00 <br /> <br /> <br />