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FOR OFFICE USE ONLY <br /> <br />LDate. <br /> <br /> MECHANICAL PERMIT APPLICATION <br /> Please complete all Sections, I through 5 <br /> <br />1. LOCATION OF INSTALLATION <br /> <br />pER/vlITS ARE NON. TRANSFERABLE AND NON-~DABLE AND <br />EXPIR.~ IF WORK IS NOT STARTED WITHIN 150 DAYS O~ i~UANCE <br />OR IF WORK IS SUSPENDI~D FOR 180 DAYS. <br /> <br />2A. CONTRACTOR INgTALI.~TXON ONLY <br /> <br />3~, FOR OWNER INSTALLATIONS <br /> <br />PmpcWj O'~r <br /> <br />Ma/lin8 Addr~ <br /> <br />Cil7/StatdZiP <br /> <br />The inrdallatlon is b{ing made on pmpcffy I own which is not igtt~nded for sMe, <br /> <br />3. PLAN REVIEW SECTION <br /> <br />We will provide plan n~view service if you complete Section <br />5B ami submit two (2) sets of plans and specification* 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 />~lC J3-41 <br /> <br />4, FEE F~unE~ULE (C~ smi ~ m~l ~ Al <br /> RI~SIDENTIAL/~] COIV/M~RCIAL [] <br /> <br />BAgR Fglg 510.00 <br /> <br />Formal Air I%'mme 5 6.00 <br />100,000 BTU or Iota <br />Owr 100,000 BTU -- $ 7.50 <br /> <br />Floor Fu.mave $ 6,00 <br />Sus~dcd Heate~ ~ $ 6.00 <br />Wall Heater __ $ 6,00 <br />Floor Moanled Unit He. alia' $ 6.00 <br />Heat Pump [~ / Air CondtfloIler [2 <br />Up to 3 Ton $ 6.00 <br />3Tonto lit Ton ~ $11.00 __ <br />Evaporative Coole~ ..... $ 4.50 <br />Exhausr Syst~an, Commercial $ 4.~0 <br />Hood end ]Exhanst, Conml~mial 5 4.~0 <br /> <br />Domestic Range Hood ..... 5 4.~0 <br />Domestic F~u~t Fans <br />and Di~ Vents $ 3.00 <br />Fire Dampor $ 3.00 <br />Wood S~ove/~q ~,_...~_ , ~ ,~ ~. ~-14_~ t~Ya ~,To~ i.~ .~- <br /> $ <br /> 7.50 <br /> ~.50 <br /> <br />Gas Water H~at~' (relocation <br />or ~r~laccm~t) $ 7.50 <br />Gas Connection <br />--p~ omlet, ~p t0 4 ~ $ 2.00 <br />--oTM 4, 58.00 pl~ m. <br />additlo~ $ <br /> <br />;For the Installation, Rdocation <br /> or Replacement of ea. Appllan~ <br /> Vent ~ot im:luded in an <br /> ApplmUCe permit. <br /> <br />Olh~ (a~ ~t~L~d by Building OrQclal) <br /> <br />3,00 <br /> <br />5. FEES <br /> <br /> A2. Add 5% ~ha~bW (.05 x Al) <br /> <br /> ¢. <br /> <br /> <br />