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! <br />FOR OFFICE USE ONLY[ <br />Received by: <br /> I <br />D. ate: T <br /> <br /> MECHANICAL PERMIT APPLICATION <br />P/ease comp/ete a// Sections, 1 through 5 <br /> <br /> 220 ni~ guest 1~ [J~ -= ,., : <br /> Salem, Oregon 97301 APB 0 I 1993 ' ~'' <br />Phone 588-5147 8:00 a,m. ~ 4:30 p.m, SITE ~t Potm~No. <br /> <br /> E~:588-7948 ~e: ~111~ ~ MO ~ ........ <br /> Issued by: <br /> <br />1, LOCATION OF INSTALLATION <br /> <br />Directions <br /> <br />PERMITS ARE NON-TRANSFERABLE AND NON-REFUNDABLE AND <br />EXPIRE IF WORK IS NOT STARTED WITIIIN ! 80 DAYS OF ISSUANCE <br />OK IF WORK tS SUSPENDED FOR /80 DAYS. <br /> <br />2A, CONTRACTOR INSTALLATION ONLY <br /> <br />No, <br /> <br />2B. FOR OWNER INSTALLATIONS <br /> <br />Cily/Sta~e/Zip <br /> <br />Tile in st~llatio n is being made on property I own which is not intended for sale, <br /> <br />.,,Owner s Signature <br /> <br /> 3, PLAN REVIEW SECTION <br /> <br />RESIDENTIAL [~ COM!VfERCIAL <br /> <br /> NEW~ ALTEEA'/ION ~-~ ~DI~ON ~ <br /> <br /> NO, x FEE <br />BASE FEE <br /> <br />Fenced Air lhnnace $ 6,00 <br />100,000 BTU or less <br />Over 100,000 BTU ---- $ 7,50 <br /> <br />Floo~ Furnace __ $ 6,00 <br />Suspended Heater ., $ 6,00 <br />Wall Heater $ 6,00 <br />Floor Mounted Unit Heater __ $ 6,00 <br /> <br />Heat ~ or Air Conditioner <br />Up to 3 Ton i $ 6.00 <br />3 Ton to 15 Ton __ $11,00 <br />Evaporative Cooler __ $4.50 <br />Exhaust System, Commercial __ $ 4.50 <br />Hood and Exhaust, Commercial __ $ 4.50 <br /> <br />Domestic Range Hood __ $ 4.50 <br />Domestic Exhaust Fans <br />a~d Dryer Vents $ 3.00 <br />Fire Damper $ 3,00 <br />Wood Stove $ 7.50 <br />Furnace Ducts (Alteration, Extcnslon) ~ $ 7.50 <br /> <br /> __ $30.00 <br /> <br />Commercial or Industrial Ixtclnerater <br /> <br />Gas Water Heater (rdocation <br />erreplacemcnt) __ $ 7.50 <br />Gas Connc'~tion <br />-per outlet, up to 4 __ $ 2.00 <br />--over 4, $8.00 plus <br />additional $ ,50 <br /> <br />For thc Installation, Ralocation <br /> or Replo~ecmeut ofea, Appliallc¢ <br /> Vent not included m an <br /> Applim~¢¢ permit, <br /> <br />Other (a.~ required by Building Official) <br /> <br />__ $ 3.00 <br /> <br />= gUM <br /> $10.00 <br /> <br />~.,OO <br /> <br />We will provide plan review service if you complete Section <br />5B and submit two (2) sets of plans and speelficationg with <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 />~C'1b-41 <br />Rev, lOt92 <br /> <br /> <br />