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FOR CITY VALIDATION <br />Received by:. <br />Date: <br /> <br />comrasNrr¥ OEVEI.OPMENT C N'I'ER ..... <br /> <br /> Salem, OR 97301 <br /> <br />24 Hr Insp~:tlo. t,i~e 588-7~14 <br />Office: $a8.5147 8;~ a_m. - 4:30 p.lll. <br />~: 5~8-794a <br /> <br /> MECHANICAL PERMIT APPLICATION <br /> Please complete all Sections, I through 5 <br /> <br />I. LOCATION O~t iNSTALLATION <br /> <br />PERMITS ARP. NON:I'RANSPERABLE AND EXPI!~E tP WORK IS NOT I <br />2A. CO~TRACTOR IHS'FALLATION ONLY <br /> <br />......................... ~ .......... ~:_~. ~ -~ <br /> <br />2B. FOR OWHBR INS'FALI~ATIONS <br /> <br /> 3. PLANRIiVII~W SECTION <br /> <br /> Marion County does IR)t require a plan review. <br /> We will provide pla. review service if you complete <br /> Section 5B aud st~bmJt two (2) sets Df plaus and <br />I specifications with lhis applicati.n, <br /> <br />fiR? 15.4 <br />Rev. 12/P4 <br /> <br /> "l N COUN[ <br />Issu Ltt :OlN0 INSPEC, TION <br /> <br />4. FEI] SCHEDULE tComplet¢ a.d enter tnml ia Al below) <br /> <br /> RESII)EIXrrlAL J~ COMMERCI~ ~ <br /> USE OP ~RUCTUR~: <br /> N[{W ~ ALTERATION ~ ADDITDN ~ ~OCATION ~ <br /> GAS D or ELECTRIC~ <br /> No. X P~ ~ 8om <br />BASE FI~I[ $10.~ <br /> <br />FORCED AIR <br /> up Io i00,{;00 BTU <br /> over 100J)00 B'IU <br /> <br />AIR CONDrrIoNER <br /> Yl-m~ am! <br /> <br />ADDfFIONAL APPLIANCES <br /> Gna WM~:r Ilcnlcr <br /> Oo~ h~g Ligker <br /> <br />6.00 <br />7.00 <br /> <br />$ 6,00 -- <br />$ 6.00 -- <br />$ <br />$ 6,00 -- <br /> <br />$ 630 <br /> <br />$ 4,50 <br />$4.~ <br />$ 4.~ <br />$4.~ <br /> <br />$ :;.CO <br />$7.5O <br />$7.30 <br />$.50.00 <br /> <br />$ 7.50 <br />$7.50 <br />$ 730 <br />$ 73O -- <br /> <br />2.00 <br /> ,$o <br /> <br />$ a.0o <br /> <br />A2. A,Jd 5% s.~¢W£g¢ 135 ~ A IX <br /> <br />Enter 25% ~,f linc A I Iht Hall Rcvbw <br />(Al + ,25), if mluird ~ <br />Inves~igatlo, Fee (if r~q,ird) <br /> <br /> TOTAL ~OUNI+ DUE <br /> <br /> <br />