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I <br /> POR OFFICE USE ONLY] <br />] Received by: <br />]Date: <br /> <br /> MECHANICAL PERMIT APPLICATION <br /> Please complete all Sections, 1 through 5 <br /> <br />MARION COUNTY BUILDING INSP~T~ <br /> <br /> ~a~em, Oregon 97301 [~ ~ <br /> <br /> l'hoa¢ 588-~t47 8~ ~- 400 p.m, SiTE ~; Pete No. <br /> ~,-~-~o.~: ~ss.7~ ~AR~ON COUNTY <br /> F~: 588-7948 D~l.m,~,~ <br /> UU~LUI$~ IIN~F[G I <br /> <br /> I~ued by: <br /> <br />I. LOCATION OFINSTALLATION <br /> <br />Job Address ~ <br /> <br />Directions <br /> <br />/PEP..MIT~ APE NON-TRANSFERABLE AND NON-PEIr0'NDABLE AND <br /> F-X PIR ]~ IF WORK IS NOT STAP. TED WITHIN I S0 DAYS OF ISSUANCE <br /> OR IF WORK IS SUSPENDED FOR I gO DAYS, <br /> <br /> 2A, CONTRACTOR INSTALLATION ONLY <br /> <br />Co.,~,,o~. Ro~ ~.s. No. ,d~?b 3,o [~o~ ~o. <br />, <br /> <br /> 2B, ~OR OWNER INSTALLATION8 <br /> <br />Phone <br /> <br />Cily/Slale./Zip <br /> <br />Ovraeff s Signatur~ <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 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 Su'uctural Specialty Code, Chapter 53. <br /> <br />Rev, 5/93 <br /> <br />4, FJ~E $CREDULE (Compk~ ~ ~ ~1 ~ Al below) <br /> RESIDENTIAL ~ COMMERCIAL [] <br /> <br /> USE OF $TRUCTOI~: <br /> <br />B~ ~E $10,00 <br /> <br />Forced Air Fumace $ 6.00 <br />100,000 BTU or less <br />Over 100,000 BTU -- $ 7.50 <br /> <br />Iqoor Furnace ~ $ 6.00 <br />SuspCro. dod Heate~ __ $ 6,00 <br />W~ll Heater __ $ 6,00 <br />P-'loot Mouuted Unit Heater __ $ 6,00 <br /> <br />Heat Pump ~ / Air Candtfioner [--~ <br />Upto 3 Ton -- $6.00 <br />3 Ton to 1~ Ton $11.00 <br />Evaporative Cooler ~ $ 4.50 <br />F, xhaust Syst~n, Com~ea~cial __ $ 4,50 <br />Hood and Exhaust, Comm~ial __ $ 4.50 <br /> <br />Domestic P, znge Hood ~ $ 4.50 <br />Domestic Exhaust Faas <br />~d Dryex Vents $ 3.00 <br />Fire Damper __ $ 3,00 <br /> <br />Furnace Ducts (Alteratiou,'Extensiou) __ $4.50 <br />Commercial or Induslrial Incinerator __ $30.00 __ <br /> <br />Gas Water I-t~ater (relocation <br />or replaceammt) -- $ 7.~0 <br />Gas Connection <br />--per outlet, up to 4 __ $ 2,00 <br />--over 4, SS,00 plus ea. <br />additiom~l $ ,$0 <br /> <br />For the Installation, Relocation <br /> or Replacement of es. Applianae <br /> Vt'at not included in au <br /> Appliance permit. <br /> <br />Other (as Rxluircd by Building Official) <br /> <br />__ $ 3.00 <br /> <br />5. FEES <br /> Al. Em~ total of Fe~ fi'om <br /> A2. Add $%surdmrg¢ (,05 xAI) <br /> <br /> C, I~v~6gaao~ F~ (if r~0~l) <br /> D. E~i.~3~cfon F~ ($25,00) <br /> <br />$ -- <br /> <br /> <br />