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FOR OFFICE USE ONLY <br />R¢ceive,l by: ~ <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> <br /> Salem, Oregon 97301 :,i~ I~ I~,i ~. <br /> ~[T~ '~; '~ Permit No, <br /> <br />MECHANICAL PERMIT APPLICATION <br />P/ease complete all Sections, 1 through 5 <br /> <br />1. LOCATION OF INSTALLATION <br /> <br />Directions <br /> <br />PERMI'LN ARF, NON-TRANSFERABLE AND NON-REFUNDABLE AND <br />EXPIILE If' WOKK IS NOT STARTED WI'IlliN 180 DAYS OF ISSUANCE <br />OR [ir WORK IS SUSPENDED FOR 180 DAYS, <br /> <br />2A, CONTRACTOR INSTALLATION ONLY <br /> <br />Coutracto~ ' <br /> <br />qWr toe,foa a P g. No. <br />Contractor ~ Signature: <br /> <br />2B, FOR OWNER INSTALLATIONS <br />Property Owner <br />Mailing Afldross Fhone <br />City/State/Zip <br /> <br />The installation ia being made on property I own which is not intended foe s~le, <br />lease, or feat, <br /> <br />Owac:fs Signature <br /> <br /> PLAN REVIEW SECTION <br /> <br />Wa will provide plan review service if you complete Section <br />5B ,'md 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 Structural Specialty Code, Chapter 53. <br /> <br />MC' IJ-4l <br /> <br />Phone 598-5147 $:00 a,m. ~ 4:30 p.m, <br />Code-A-Phone: 588-7904 <br /> FAX: 58g-7948 <br /> <br />Rev, 10192 <br /> <br /> ui.; 1 <br /> Date: <br /> MARION <br /> Issued by:J'i/.I.m~.^ ,, <br /> <br /> KESIDENTIAL [~f COMMEKCIAL <br /> <br />BASE FEE <br /> <br />Forced Air ]hnnace I ,, $ 6-00 <br />100,000 BTU er less <br />Over I00,000 BTU -- $ 7.50 <br /> <br />Floor Fusaace __ $ 6.00 <br />Suspended Heater __ $ 6.00 <br />Wall Heater __ $ 6.00 <br />Floor Momlted Unit la,~ater __ $ 6.00 <br /> <br />I-[eat Pump or Air Conditioner <br />Up to 3 Ton -- $ 6.00 <br />3 Ton to 15 Ton $11 <br />Evaporative Cooler __ S 4.50 <br />Exhaust Systm, Commercial __ $ 4.50 <br />Hood and Exhaust, Commercial __ $ 4,~0 <br /> <br />Domestic Range Hood __ $ 4,30 <br />Domestic Exhaust Fans <br />and Dryer Vents __ $ ~,00 <br />rite Damper __ $ 3.00 <br />Woo~ Stove / $ 7-~0 <br />Pumace Ducts (Alteration, Extension) __ $ 7.$0 <br /> <br />Commercial or Industrial Incinerator __ $30,00 <br /> <br />Gas Water l-I¢at~r (relocation <br />or replacemcmt) __ $U.50 <br />Gas Connection <br />--per outlet, ap to 4 .~4~ $ 2.00 <br />--over 4, $~.00 plus <br />additional __ $ <br /> <br />For the Installation, Relocation <br />or Replacamenl of eR. Appliance <br />Vent not included in an <br />Appliance permit. __ $ 3.00 <br /> <br />Other (as reqaired by Building Official) <br /> <br />SUM <br /> <br />$10,00 <br /> <br />5. FEES <br /> Al, Enter total or F¢~s from S~c, #4 <br /> A2, Add $%n~rcharg¢ (,0~ xA1) <br /> <br /> Subtotal <br /> <br /> <br />