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FOR CITY VALIDATION] <br />Received by: ] <br />Date: I <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> COMMUNITY DEVELOPMENT CENTER, <br /> 285 Church St NE · Room 132 PI~RMIT NO: <br /> Salem, OR 97301 <br /> <br /> MECHANICAL PERMIT APPLICATION <br /> P/ease complete al~ Sections, I through 5 <br /> <br />1. LOCATION OF iNSTALLATION <br /> <br />City ~ <br /> <br />24 Hr In~pex~tlon L~ae; 568-7904 <br />Office.: 588-5147 8;00a.m.-4:30p.m. <br />FAX: 588-7948 <br /> I <br /> <br />PERMITS ARE NON-TRANSFI:~RABLE AND EXPIRE IF WORK IS NOT <br /> STARTED WI'I~IN 180 DAYS OF ISSUANCE OR IF <br /> WORK IS SUSPENDED FOR 180 DAYS, <br /> <br />2A, CONTRACTOR INSTALLATION ONLY <br />~ailing Addi~ <br /> <br />Conlractor's Boaal Reg. No. I Job No, <br /> <br />Agenl'$ Signature; <br /> <br />Date: <br /> <br />Issued by: <br /> <br />4. FEE SCHEDULE (Complete and enter total in Al below) <br /> <br /> RESIDENTIAL ~1, COMMERCIAL <br /> USE OF STRUCTURE: <br /> NEW 121 ALTERATION [2 ADDITION ~3 RELOCATION <br /> <br /> GAS 0 or ELECTRIC O <br /> No, X P~o = Sum <br />BASE FEE $10.00 <br /> <br />PORCED AIR FURNACE <br />up 4,10o,0oo _L__ $ 6.00 <br />over 100,000 BTU $ TOO <br /> <br />FLoor Furnace $ 6,00 <br />Suspended Heater $ &fib <br />Wall Heater $ 6,00 <br />Floor Mounted fleuter $ 6,00 <br /> <br />HEAT p I, Rvl p <br />u~der 3 Tor~ $ 6.50 <br />3 Ton and up $11.00 __ <br /> <br />AIR CONDITIONER <br />under 3 Ton $ 6.50 <br />3 Ton and up $11.00 <br /> <br />EvaporativeCooler $ 4,50 ........ <br />Commercial Exhaust System $ 4.50 __ <br />Commercial Hood arid I~xhau~t $ 4.50 <br />Doalesti¢ Range Hood $ 4.50 <br />Domestic Exhaust <br />and Dty~ Vents $ 3,00 <br />llir~ Damper $ 3.00 ........... <br />Wood Stovc/Fircplaee $ 7,50 __ <br />~UrllaCC Duc~ (Altexation/Extenalon) $ 7,50 __ <br />Commercial / Indualfial inelnerator $30.00 <br /> <br />ADDiTiONAL APPLIANCES <br />w.= H.= { ,7.50 <br />Gas Log Lighter $ 7.50 <br />Gao Barbequ¢ $ 7,50 <br />OIh~r $ 7.50 <br /> <br />GAS PIPING SYSTEM <br />I-4 outlets (per dude0 7_. $ 2.00 <br />4 and up outlets (per earle0 $ ,50 <br /> <br />Appliance Vents not inelmled ia <br />an appliance permit <br /> <br />OTHER (as required by Bmldit~g Ol~claO <br /> <br />DWELLING PERMIT LAtffiL # of Labela <br /> <br />$ ZOO <br /> <br /> 3. PLANRBVIEW SECTION <br />IMarion County does not require a plan review, <br />ye will provide plan review service if you complete <br />Section 5B and submit two (2) sets of plans and <br />specifications with this application. <br /> <br />MC I,%4 / <br />I~ 12/94 <br /> <br />5. FEES <br /> <br /> D. Rcinapection Fee ($25,00) <br /> <br /> TOTAL AMOUNT DUE <br /> <br /> <br />