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FOR, OFFICE USE ONLY <br />Received by: <br />Date: .... <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> <br />IMECHAN'ICAL pERMIT APPLICATION <br />P/ease complete all Sections, 1 through <br /> <br />220 High Street NE <br />Salem, Oregon 97301 <br /> <br />Phoo¢ 588-5147 8:00 a.m. ~ 4:30 p,m. <br />Code-A-Phone; 588-7904 <br />~AX; 58s-7948 <br /> <br />pERMITS AI~E NON.TRANSFERABLE AND NON-P-~FUNDABLE AND <br />EXPIRE IF WORK IS NOT STARTED WI' fFllN 180 DAYS OF ISSUANCE <br />OR IF WOR~ IS SUSPENDED FOR, 180 DAYS, <br /> <br /> 2A. CONTRACTOR INSTALLATION ONLY <br /> <br />FOR OWNER INSTALLATIONS <br /> <br />Property Owner <br />Mailiag Address Phone <br /> <br />City/State/Zip <br /> <br />The iastallafion is being made on property ! own which is not inlended for sale, <br /> <br /> 3, PLAN ILEVII~W SitCTION <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 pwgr',un does not suspend the <br />required submission &plans, and specifications when required <br />by tile Oregon Structural Specialty Code, Chapter 5% <br /> <br />Rev. 10/92 <br /> <br />Perl:nlt <br /> <br />4. FI~ $OtEnULE (Complete ~d enter total in A I I~low) <br /> RESIDENTIAL ~ COMMERCIAL [~ <br /> <br /> NEW~] ALTERATION ~ ADDmON ~rP,.ELOCATION [~ <br /> <br />I~ASEFER / ~o. x ~ - su~ <br /> $10.00 <br /> <br />Forced Air Furnace $ 6.00 <br />100,000 BTU or less <br />Over 100,000 BTLI $ 7.50 <br /> <br />Floor ~b'~mmce __ $ 6.00 <br />Srrspend~d Heater $ 6.00 <br />Wall Heater __ $ 6.00 <br />Floor Mounted Unit Heater S 6.00 <br /> <br />Heat B~ap or Air Condition~: <br /> Up to 3 Ton <br /> 3 Ton to 15 2'on <br />Evaporative Cooler <br />Exhaust System, Connnorcial <br />Hood and Exhaust, Commercial <br /> <br />Domestic Ranse Hood <br />Domestic Exhaust Faus <br />and. Dryer- Vents <br />Fire Damper <br />Wood Stove <br />~mace D~cts (Alt~ation, Ext~ion) <br /> <br />Commercial or Industrial Incinerator <br /> <br />Gas Water Heater (relocation <br />or replacement) <br />Gas Com~ection <br /> --per outlet, np to 4 <br /> --over 4, $8.00 plus es. <br /> additional <br /> <br />For thc Installation, Relocation <br /> or Replacement ofea. Applianae <br /> Vent not included ia all <br /> Appliance permit. <br /> <br />Other (as required by Building Ofllcial) <br /> <br /> . $6.00'/~',~;d~" <br /> $11,00 <br /> $ 4.50 <br />__ $ 4.50 <br /> $4.50 <br /> <br />__ $4.50 <br /> <br /> $ 3.00 <br />__ $ 7.50 <br /> $ 7.50 <br /> <br /> $30.00 __ <br /> <br />__ $ 7,50 ~ <br /> <br />__ $ 2.00 <br /> $ .50 <br /> <br />__ $ 3.00 <br /> <br />5. FEES <br /> <br /> A2. Add $% em'eha~s¢ (.0~ x Al) <br /> <br /> D, Re~l*eetlon Fee ($2L00) <br /> <br /> TOTAL AMO~T DUE <br /> <br /> R~c,~t No. <br /> <br />*1% <br /> <br />$ __ <br />$ <br /> <br /> <br />