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~ ReCeived by: <br /> <br />IMECHANICAL PERMIT APPLICATION <br />Please complete all Sections, 1 through 5 <br /> <br />Phone 581L-$147 8.'00 a.m. ~ 4:30 p.m., <br /> <br /> FAX: $S8-7945 <br /> <br />Issued by: <br /> <br />LOCATION OF INSTALIakTION <br /> <br />City ~c,~qoK~ I Cro~ St. <br /> <br />PEP, MITS APJE NON.TII~NSFEI~ABLE AND NON.REFUNDABLE AND <br />HXPIIUB IF WORK IS NOT STARTED WITHIN 180 DAYS OF I~SUANCE <br />OP. IF WoRK IS SUSPENDED FOR 180 DAYS. <br /> <br />Prope~'ty Owuc~ <br />Mailing Address Phone <br />City/State/Zip <br /> <br />The ias~.llatioa is being msde on pmpe~' I own which is not intended {'or ~le, <br /> <br />3. PLAN REVIEW SECTION <br /> <br />: We will provide plan review service if you complete Section <br />5B and submit two (2) zets of plans and specifications with <br />this application, <br /> <br />This optional plar~ review prograsu does not suspend the <br />requixed submission of plans, and specifications when required <br />by the Oregon Stractural Specialty Code, Chapter 53. <br /> <br />~ICI§.41 <br />Rev, 5/93 <br /> <br />P,t~SIDENTIAL [~' COMMERCIAL [] <br /> <br /> NEW~ ALTERATION ~ AnOITION [] RELOCATION ~ <br />a~S~ ~L~cxmc~ No. x ~E = SuM <br />~ $10.00 <br /> <br />Forced Air Furnace ~ $ 6.00 <br />100,000 BTU or le~ <br />Over 100,000 BTU -- $ 7.50 <br /> <br />Floor Funmce __ $ 6,00 <br />Suspended Heater $ 6,00 <br />Wall Heater $ 6,00 <br />F/oor Mooated Unit l~ater $ 6.00 <br /> <br />Heat Pump [] / Air Conditioner [] <br />Up to 3 Ton __ $ 6,00 <br />~ Ton ~o 15 Ton $11.00 <br />Evaporative Cooler ~ $ 430 <br />By, haust System, Commercial ~ $ 430 <br />Hood and Rxhaust, Commea~ial $ 4.50 <br /> <br />Domest/c Range Hood $ 4,50 <br />Domestic ]Lx~anst Fan~ <br />and Dryer Vents $ ~.00 <br />Fire DamI~t $ 3.00 <br />Wood Stove ~ $ 7,50 <br />Fttmace Du~ts (Alteration, Extension) __ $4.50 <br /> <br />Commercial or Industrial Iudn~atet $30,00 <br /> <br />Gas WaTer Heater (relocation <br />or replacement) ~ $ 7.50 <br />Gas Col~c~on <br />-per outlet, up to 4 ~ $ 2.00 <br />~-ov~ 4, $8.00 pl~ eR, <br />additio~ $ .50 <br /> <br />~ $ 3,00 <br /> <br />For the Installation, Relocation <br /> or Replacement of ea. Appliauce <br /> Vemt not included in an <br /> Appliance permit, <br /> <br />Other (as rcquirud by Builddug Official) <br /> <br /> <br />