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IFOR CITY VALIDATION <br /> Re~eivcd by: <br /> <br /> ~u]LDING INS, <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> COMMUNITY DEVELOPMENT CENTER PERMIT NO: <br /> 2S5 Chut¢[l St NE ' Room [32 <br /> Salem, OR 97301 <br /> Date: <br /> <br />J PERMITS A~ NON-~ANSF~BLE AND ~HRE IF WORK IS NOT I <br /> S rAKeD ~IN <br /> WO~ IS ~,~ND~ FOR lBO DAYS, <br /> CO~RACTO~ <br /> <br /> FOR OW~R <br /> <br /> Properly Owner ¢let~sc print) <br /> <br /> 3. PLAN REVIEW SECTION <br /> <br /> Marion County does not require a plan review. <br />J We will provide plan review sen, ice if you complete <br />[Section 5B and submit two (2) sets of plans and <br />[specilicafions with this applicafiom <br />MC 15-41 <br /> <br />Issued by: ,,, <br /> <br /> 4. '][~ SCX-It~L~ (COlllplete and enter ~)~l <br />NTY qo~ci~ <br />~CTin~, ~sm~ ~ <br /> N~W a AL~ATION O <br /> GAS g or ~EC~IC ~ <br /> N~ X <br /> BASE FEE <br /> <br />FORCED AIR FURNACE <br /> up to 100,000 BTU <br /> over I(×},000 <br /> <br />Floor Furnace <br />Suspended Heater <br />Wall Heater <br />Floor MoiJBted Heater <br /> <br />HEAT P~P <br /> ~der 3 Ton <br /> 3 Ton and ap ~,. <br /> <br />~R CON~ITIO~R ~r 3 ~n <br /> <br />ADDITIONAL APPLIANCES Gas Water Hea'~t <br /> Gaa Log Lightor <br /> Gas Barb~que <br /> <br />GAS PIPING SYSTEM <br /> <br />OTHER (as ~uired by BoiI~ O~cia 0 <br /> <br />DWELLING ~IT L~EL g of ~b~ls <br /> <br />$ 6-00 <br />$ 7,00 <br /> <br />$ 6.(×) <br />$ 6.(X) <br />$ 6.iX) <br />$ 6,¢X) <br /> <br />$ 6,50 <br />$11.00 -- <br /> <br />$ 6,50 __ <br />$11.00 . <br /> <br />$ 4,5(I <br />$ 4.50 <br />$ 4,50 __ <br />$ 4.50 .... <br /> <br />$ 3,00 <br />$ 3,(×) .... <br />$ 7.5O ........ <br />$ 7.5O <br /> $30.00 --- <br /> <br />$7.5O -- <br />$ 7,50 <br />$7.5O <br />$7.50 ~ <br /> <br />$ 2,tX) <br />$ ,50 , <br /> <br />$ 3,(D <br /> <br />B, Enter 25% of Em~ A t foe plan I~viaw <br />(A 1 + .25), if rcqui~d $ <br />C, Investigation Fee (if required) $ <br />D, Reinspcctioa Fee ($~5,~) <br /> <br /> TOT~ ~O~1' DUE $~ ~ 3 <br /> <br /> <br />