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FOR OFFICE USE ONLY <br />Received by: <br />Dat,~e: <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> <br /> Salem, Oregon 97301 *~ <br /> <br />MECHANICAL PERMIT APPLICATION <br />Please complete all Sections, I through 5 <br /> <br />1, LOCATION OE INSTALi,ATiON <br /> <br />Phone 5gg-51a7 g;00 a,m, ~ 4:30 p.m. <br /> Code-A-Phone: 588-7904 <br /> FAX: SgS.7O4S <br /> <br />PERMFrS ARE NON.TRANSFERABLE AND NON-REFUNDABLE AND <br />EXPIRE IF WORK IS NOT STARTED WITItlN I so DAYS OF ISSUANCE <br />OR If WORJ~ IS SUSPENI)EI) FOR 180 DAYS. <br /> <br /> 2A. CoN'rI, L&CTOR INSTALLATION ONLY <br /> <br />Contractor'~ Licenae No. <br /> <br />Contrae,oe~Boardgeg. No. / )I / ....... I$obNo. <br /> <br />2B. FOR OWNER INSTALLATIONS <br />tPrope~ty Owner <br />Mailing Addreas Phone <br />City/State/Zip <br /> <br />Th~ installation is being made on properly I own which is not intended for sale. <br /> <br />Owncgs Signature <br /> <br /> 3. PLAN REVIEW SECTION <br /> <br /> SITE #: a ~.~ <br /> £ 9 995 <br /> Date: ~Z~I <br /> ION COO <br /> iNSPECTiON <br />~SIDE~ ~ CO~RCI~ <br /> <br />Forced Air Foraace / $ 6.00 <br />100,000 BTU er less <br />Over 100,000 BYIJ -- $ 7.50 <br /> <br />Floor Furnace $ 6,00 <br />Su~p~mdcd Heater __ $ 6.00 <br />Wall Heater __ $ 6.00 <br />Floor Mounted Unit ~eater __ $ 6.00 <br /> <br />Iteat Pump or Ak Conditioner <br /> Up to 3 Ton <br /> 3 Ton to 15 Ton <br />Evaporative Cooler <br />Exhaust System, Commercial <br />Hood and Exhaust, Commercial <br /> <br />Domesti~ Range Hood <br />Domestic Exhaust Fans <br />and Dryer %rots <br />Fire Damper <br />Wood Stove <br />Furnace Ducts (Alteration, Extension) __ <br /> <br />Commercial or Industrial Incinerator <br /> <br />Gas Water IIeater (relocation <br /> or replacement) <br />Gas Connection <br /> --per outlet, up to 4 <br /> --over 4, $8.00 plus ea. <br /> additional <br /> <br />For the Installation, Relocation <br /> or Replacement of ea. Appliance <br /> Vent not mclnded in an <br /> Appliance ]mnnit. <br /> <br />Other (as required by Building Official) <br /> <br />$ 6.00 <br />$11.00 <br />$4.50 <br />$ 4.50 <br />$ 4.50 <br /> <br />__ $ 4.50 <br /> <br />__ $ 3.00 $ 3,00 <br /> $ 7.50 <br /> $ 7.50 <br /> <br />__ $30,00 <br /> <br />7.50 <br />2.00 <br />.50 <br /> <br />__ $ 3.00 <br /> <br />$10.00 <br /> <br />We will provide plan review service if you complete Section <br />5B and submit two (2) sets of plans and specifications with <br />this application. <br /> <br />This optional plan review program does not suspend Qze <br />required submission of plans, and specifications when required <br />by the Oregon Structural Specialty Code, Chapter 53. <br /> <br />Reu, 10/92 <br /> <br />5, FEES <br /> <br />5 ,2 7, fSC: <br /> <br />$ <br /> <br />$ <br />$ __ <br />$ __ <br /> <br /> <br />