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[FORX)FFICE USE ONLY <br /> Received by: <br /> Date: <br /> <br /> MARION COUNTY BUILDING INSPECTI.,iO~N~, <br /> <br /> Salem, Oregon 97301 <br /> <br /> PhoneSS$-5147 8:00a,m.~4:30p.m. SITE <br /> ~c.A-Phone: 598-7904 <br />MECHANICAL PERMIT APPLICATION ~: 5SS-7048 D~e: <br />Please complete all Sections, I through 5 <br /> I~ued <br /> <br />LOCATION OF INSTALLATION <br /> <br />)irectlons <br /> <br />/PERMITS ARE NON-TRANSFERABLE AND NON.REFUNDABLE AND <br /> · ]~PIRE IF WOP, K IS NOT STARTED WITHIN 180 DAYS OF ISSUANCE <br /> OR IF WORK IS SUSPENDED FOR 180 DAYS, <br /> <br />2A. CONTRACTOR INSTALLATION ONLY <br /> <br /> 2E. FOR OWNER INSTALLATIONS <br />Property Owner <br /> <br />City/StatdZip <br /> <br />3, PLAN REVIEW SECTION <br /> <br />RESIDENTIAL [] COMMERCIAL~ <br /> <br /> USE OF STRUCTURE: <br /> <br /> NO. X FEE = SUM <br />R~ ~E $10.00 <br /> <br />Forced Afl Fun~e <br />100,000 BTU or less <br />Over 100,000 BTU <br /> <br />Floor l~,~uacc <br />Suspea~d Heater <br />Wall Heater <br />Floor Mounted Unit Heater <br /> <br />H~t Pump or Air Conditioner <br /> Upto 3 Ton <br /> 3 Ton to 15 Ton <br />Evaporative Cooler <br />EXhamqt System~ Coram~to/ui <br />Hood and Exhaust, Commercial <br /> <br />Demc~ie Range Hood <br />Domestic Exhaust Fans <br /> and Dryer Ve~ts <br />Fire Damper <br />Wood Steve <br />Furnace Ducts (Alteration, Extansioll) <br /> <br />Commercial or Industrial Incinerator <br /> <br />$ 6.00 <br /> <br />-- $ 7,50 <br /> <br />,,, $ 6.00 <br />__ $ 6.00 <br />.-A- $ 6.00 <br />__ $ 6.00 <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 />$ 7.50 <br /> <br />$30.00 __ <br /> <br />Gas Water Heater (rclocation <br /> or replacement) <br />Gas Connect/on w/o Appliance <br /> --per outlet, up to 4 <br /> --over 4, $8.00 plu~ ea. <br /> additional <br /> <br />__ $ 7.50 <br /> <br />__ $ 2.00 <br /> $ .50 <br /> <br />For the Installation, Relocation <br /> or Replacean~t of ca. Appliance <br /> Vent not included ia an <br /> Appliance permit. <br /> <br />3.00 <br /> <br />Other (as required by Building Official) <br /> <br />We will provide plan review service if you complete Section <br />5B and submit two (2) ,er, 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 required <br />by the Oregon Structural Specialty Code, Chapter 53. <br /> <br />~C~J-41 <br /> <br />Rev, 2/92 <br /> <br />5, FEES <br /> Al. ~ater total of F~ from Sec, ~4 <br /> A2. Add $%~.rchargc (.05 hal) <br /> <br /> Subto~l <br /> <br /> (Al x 15) if mqu~d <br /> C lav~tigation F,~ (if requital) <br /> <br /> <br />