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FOR, OFFICE USE ONLY <br />R. ece~ved' by: <br />Dale: .... <br /> <br />MARION COUNTY BUILDING INSPECTION <br />COMMIJNITY DEVI~LOPMENT CENTER <br />285 Church St. NE - Room 132 <br /> Salem. Oregon 97301 <br /> <br /> Phone 558-5147 $:00 ~cm - 4:30 p,m, S]T~ <br /> Code-A-Phone: 588-7904 <br />MECHANICAL PERMIT APPLICATION I ,~=sss.7~na Date: <br />Please complete all Sections, 1 through 5 I~ued by: <br /> <br />Permit No <br /> <br />t, LOCATION OF INSTALLATION <br /> <br />PERMITS ARE NON.TRANSFERABLE AND NON-ILEFUNDABLE AND <br />EXPIRE IF WORK IS NOT STAKI~D ~TrltrN 180 DAYS OF ISSUANG]~ <br />OR IF WOP~K IS SUSPENDED FOR lEO DAYS <br /> <br /> 2A, CONTRACTOR INSTALLATION ONLY <br /> <br /> FOR OWNER INSTALLATIONS <br /> <br />Mailit~g Address Phone <br /> <br />The inatallation iS being made on propert~ i own which is not intended for sale, <br /> <br />3. PI,AN REVIEW' SECTION <br /> <br /> RESIDENTIAL ~ COMMERCIAL [] <br />BASE FEE $10,00 <br /> <br />Forced Par Fusaace $ 6,00 <br />100,000 BTU or less <br />Over 100,000 BTU -- $ 7,50 <br /> <br />Floor Fumacc $ 6.00 <br />Suspended Heater __ $ 6,00 <br />Wail IIeater $ 6,00 <br /> Unit Heater ~ $ 6,,00 <br />Floor <br /> Mounted <br /> <br />Heat Pump [] / Air Conditioner ~] <br />Up to 3 Ton -- $ 6,00 <br />3 Ton to 1 $ Ton $11 00 <br />Evaporative Coolex __ $ 4 50 <br />Exhaust System, Commercial __ $ 450 <br />Hood and Exhaust, Commemial __ $ 450 <br /> <br />Domestic Range Hood __ $ 450 <br />Domestic Exhaust Fans <br />and D~-ex Vents __ $ 300 <br />.~re Damper $ 3,00 <br />Wood Stove ~- $ 7,50 <br /> Furnace Ducts (Alteration, Extension) __ $4,50 <br /> <br />Commercial or Industrial l[ncinerator __ $3000 <br /> <br />Gas Water Hentex (relocation <br />or replacement) __ $ 750 <br />Gas Connection <br />--per outlet, up to 4 __ $ 2,00 <br />--over 4, $8,00 plus ea, <br />additional $ 50 <br /> <br />For the Installation, Relocation <br /> or Replacement ofea, Appliance <br /> Vent not included in an <br /> Appliance permit <br /> <br />Other (as required by Building Official) <br /> <br />__ $ 3,00 <br /> <br />We will provide plan review Service if you complete Section <br />5B and submit two (2) sets of plans aad specifications vath <br />this application, <br /> <br />This optional plan review program does not suspend the <br />requited submission of plans, and specifications when required <br />by the Oregou Structural Specialty Code, Chapter 53 <br /> <br /> FEES <br /> <br />A2 Add 5% a'urelaa'gc ( 05 x A 1 ) <br /> <br /> Subtoml <br /> <br /> ~nt~r 25% of line Al for Plan Review <br /> (Al x ,J~5) itrequired <br />C Inwatigation F¢¢ (ff i~qutted) <br />D R¢inspcetion 1:¢¢ ($25 00) <br /> <br /> TOTAL A MOUNT DUE <br /> <br /> <br />