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] OR OmC use <br />Received by: (~- 4 <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> <br />220 High S~et N~ <br />Salem, Oregon 97301 <br /> <br />Phoa~ 5SS-~147 $:00mm. ~ 4:30 p.m. <br />Code-A-Phone:SSS-?904 <br /> FAX; 588-7948 <br /> <br />MECHANICAL PERMIT APPLICATION <br /> I <br />f/ease complete ali Sections, I through 5 I <br /> <br />SITE #: <br /> <br />Date: <br /> <br />Issued by: <br /> <br />1. LOCATION OF ]NSTALLATION <br /> <br />Dire~ion~ <br /> <br />?EP, M~T$ AKE NON-TRANSFERABLE AND NON-REFUNDABL~ AND <br />FaXPIR~ IF WORK IS NOT STARTED WITHIN 1 S0 DAYS OF ISSUANCE <br />OR IY WORK IS SUSPENDED FOR l S0 DAYS. <br /> <br /> 2A, CONTRACTOR INSTALLATION ONLY <br /> <br />~ontraeto~ <br /> <br />Mailing Address <br /> <br />Propgr~y OWner <br /> <br />Board R~g. No. <br /> <br />JPhon* <br /> <br />J Sob No, <br /> <br />2B, FOR OWNER INSTALLATIONS <br /> <br />Thc installation is b¢iog made on property I own which is not intonded for sale, <br /> 3. ?LAN REVIEW S*'CTION <br /> <br />KESIDENTIAL [_~[ COMMERCIAL [] <br /> <br /> USE OF STRUCTLrlLE: <br /> <br /> NO, X FEE <br />BASE ~E <br /> <br />Fomed Air F~ma~e $ 6.00 <br />100,000 BTU or less <br />Over 100,000 BTU --, $ 7,50 <br /> <br />Floor Furnace __ $ 6,00 <br />Suspended Heater __ $ 6.00 <br />Wall Heater __ $ 6,00 <br />Floor Mounted Uint Yleater __ $6.00 <br /> <br />Heat l:'m~p or Air Cmaditianer <br /> Up to 3 Ton <br /> 3 Ton to 15 Ton <br />Evaporative Cooler <br />Exhaust Systc'm, Commercial <br />Hood and Exhaust, Commercial <br /> <br />-- $ 6,00 <br /> $11,00 <br /> $4,50 <br />__ $ 4,5o <br />__ $ 4,5o <br /> <br />Domestic Range Hood -- $ 4.50 <br />Domestic Exhaust Fans <br />and Dryer Veats __ $ 3.00 <br />Fire Damper __ $ 3.00 <br />Wood Stove / $ 7,50 <br />Furnace Ducts (Alteration, Extension) __ $ 7,50 <br /> <br />Commc'rcial or I~dus~al I~cinerator __ $30.00 __ <br /> <br />Gas Water Heater (relocation <br />or replacemc'nt) __ $7.50 <br />Gas Connection w/o Appliance <br />--pe~ outlet, up to 4 __ $ 2.00 <br />-ove~ 4, $8,00 pl~s ea. <br />additional $ ,50 <br /> <br />For the Installation, Relocation <br /> er Replacement ofea, Appliencc <br /> Vent not included m an <br /> Appliance permit. <br /> <br />Other (as required by Building Official) <br /> <br />__ $ 3.00 <br /> <br />$10.00 <br /> <br />We will provide plan review service if you complete Section <br />5B and submit two (2) set$ of plans and specifications with <br />this application. <br /> <br />This optional plan review pro.am 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 1§-41 <br />Rev, 2/92 <br /> <br />5. gEES <br /> <br /> Al. Emue total of F,e~ from S~¢. 84 <br /> A2. Add 5% ~nu~ohatg¢ (.05 x A 1 ) <br /> <br /> Subtotal <br /> <br /> (Al x .25) if n:quit~l <br /> <br /> Receipt No. g80/ <br /> <br /> <br />