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IFOR OFF[CE USE ONLY <br /> Received by: <br /> Date: <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> <br />220 H/gh $~reet NE <br />Salem, Oregon 97301 <br /> <br />Phone 588-5147 8:00 a.m. ~ 4:30 p,m. <br />Code-A-Phone:588-7904 <br />FAX:588-7948 <br /> <br />MECHANICAL PERMIT APPLICATION 5 <br />Please complete all Sections, 1 through <br /> <br />SITE #: <br />Date: <br />issued by: <br /> <br />l, LOCATION OF INSTALLATION <br /> <br />Contractors Liccn~ No, <br />Contracto~s~oardReg. No, ~.~ 3 I:ob o, <br /> <br /> 2B. FOR OWNER IN$TALLATION$ <br /> <br />Pwpcfly Owner <br /> <br />City/Sate/Zip <br /> <br />Owners Signa/ur~ <br /> <br /> PLAN REVIEW SECTION <br /> <br />BASE FEE $ l 0.0 0 <br /> <br />Forced Air F~raace ~_ $ 6.00 ~,.~ ~ O <br />100,000 BTU or less <br />Over 100,000 BTU -- $ 7.50 <br /> <br />Floor Furnace $ 6,00 <br />Suspeaded Heater __ $ COO <br />Wall Heater __ $ 6.00 <br />tqoor Mounted Unit Heater $ 6,00 <br /> <br />Heat Pump or Air Conditioner <br /> Up to 3 Ton <br /> 3 Ton to 15 Ton <br />Evaporative Cool~ <br />Exhaust System, Commercial <br />tIood and Exhaust, Commercial <br /> <br />Domestic Range Hood <br />Domestic Exhaust Fans <br />and Drycr V~mts <br />Fire Damper <br />Wood Stove <br />Furnace Ducts (Alteratioa, Extension) __ <br /> <br />Comm~cial or Industrial Incinerator <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 />Oas Water Heater (relocation <br /> or replacement) <br />Gas Conucction <br /> --per outlet, up to 4 <br /> --over 4, $8.00 plus ca, <br /> additional <br /> <br />__ $ 7.50 <br /> $ 2,00~, <br /> <br />$ .50 <br /> <br />For thc Installation, Relocation <br /> or Replacem~mt of ca, Appliance <br /> Vent not included in an <br /> Appliance p~mnit. <br /> <br />Other (as required by Building Official) <br /> <br />__ $ 3.00 <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 the <br />required submission of plans, and specifications when requked <br />by the Oregon Structural Specialty Code, Chapter 53. <br /> <br />$, FEES <br /> <br /> D. Relml~eSo. Fee ($25.00) <br /> <br />S <br /> <br />$ __ <br /> <br />~ Cr 1).4J l%eceipt No. <br />Rev. 10/9'2 <br /> <br /> <br />