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FOR CITY VALIDATION <br />Received by:. <br /> <br /> Please complete all Sections, I through <br /> <br />t, LOCATmN OV mSr a. LATXON <br /> <br />COMMUNITY DEVELOPMENT CENTER <br />285 Chnrch ~t NE · Room I~2 -~' ~ .... ~ ~. ,~ ~5'~ :;~ <br />S~, OR 97301 <br /> <br /> ~ Hr Ink.tiDe L~ 58~7~ iSSU~ b~ <br /> O~ 58~147 8:~a~.~4:30p.m. <br /> F~: 588-79~ <br /> <br /> 4. ~ ~H~ (Complet~mlOent~tal~Al below) <br /> <br /> ~SID~I~ COMM~CI~ <br /> U~ OF ~RUCT~ <br /> N~ ~ ~TiON <br /> GAS ~ or ~C~IC <br /> <br />PI/RMITS AP~ N ON-TRAN SF'EIO~BLE AND ~ <br /> STAR~ ~ I~ DAYS OF I$~U~ OR IF <br /> WO~ lS SUS~ ~OR 1~ DAYS. <br /> <br /> CO.ACTOR ~LA~ON O~Y <br /> <br /> / <br /> <br /> FOR O~ <br /> <br />~y Owner ~l¢as~ p~) <br /> <br />We will provide plan review service if you complete <br />Section 5B and submit two (2) sets of plans and <br />s.pecificati0ns with this application. <br /> <br /> No. X Fee = Sum <br />BASE FEIE $1o,o0 <br /> <br />FORCED AIR NURNACl/ <br />up ~ 1~,~ B~ $ <br />over 1~,~ g~ <br /> <br />~eded Heater <br />Wall H~r <br />~c Mo~ted H~tet <br /> <br />~AT <br />~r 3 Ton $ 6,~ <br /> $11~ <br />3 TOn md up .... <br /> <br />~R CO~I~O~R <br />~r 3 Ton $ 6.50 <br />3 Ton ~d up $1 <br /> <br /> ~rci~l H~ ~ <br /> ~ti~ Rm~ ~ $ 4.~ <br /> <br />B. Etl~r25% oflitl~Al fotPlan R~vi~w <br />(Al * .25), if r~qulmd $ <br />C, lav~atigatlon <br />D. Rei~p¢;tlon F~e <br /> <br /> · OT, - otnvr <br />Rt~elpt NO, <br /> <br /> <br />