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FOR CITY VALIDATION Received by: I Date: , , I MECHANICAL PERMIT APPLICATION ~b~lease complete all Sections, I through 5 ~ 1.~OCATION OF INSTALLATION pE~Mi~S 'AR~ NON.TRANSFERABLE AND F~/PiR~ iF WORK i~ NOT STARED WITHIN 180 DAYS OF ISSUANCI/OR IF WORK IS SUSPENDF~D FOR ! 80 DAYS , 2A. CONTRACTOR I~ISTALLATION ONLY Fhonc MARION COUNTY BUILDING INSPECTION 285 Chu~h St NE · Room 132 ~RMIT NO: - Salem, OR 97301 Date: :F~: 5~7948 RE~DE~I~ ~ COMMERCI~ ~ NEW ~ AL~ATION ~ ADD,ION ~ R~OCATiON ~ GAS ~ 9r ELEC~IC ~ No. X F~ ~ 5urn BASE FEE $i0.~ Mailir4g Addr~a~ ~iI Sob No, ~ Property Owner (please print) ,~ ! ~ ~ _ ~ , , ,~~~ ': ~ f/p'~rio.n. County dOeS ~ot require a plan review. ' " e will provide plan review service if you complete ectio.~n 5B and submit two (2) sets of plans and ecif!cafion~ with this application. M~ 15-41 FORCED AiR FURNACi/ up to i00,000 BTU over 100,000 BTU $ 7,00 Floor Furnace guepcnded Heater $ 6.00 Wail H~atcr $ 6,00 Floor Mounted Heater $ 6,00 IU~AT pUMP tinder 3 Ton $ 6,50 3 Ton and up ~ Sil.00 AIR CONDITIONRR under 3 Ton $ 6,50 3 Tea and up $11 E~raporm~iV~l~ $ 4.~ ~mm~ial E~aust $ya~m $ 4,~ ~mmomial Hood and E~a~l .,, $ 4.~ ~ne~tlc R~ge H~d ~d D~er V~nts . $ 3.~ .. Flm Damper $ 3,~ ~mme~ial / Iadus~al IncJne~tor ADDITIOHAL APPLIANCES Gas Water Heater Gas Log Lighter $ 7,f~O Oth~r $ 7.50 OAS PIPING SY$'I~M 1.4 outlct~ (per outlet) ~ $ 2.00 4 and up o0tlc~ (per outlct) $ ,50 OTHER (aa t*q~iwd by Bailddt~ Ol~cie0 DWELLING P/~RMIT LABEL ,f of Lal~ll 5. FEES A 1, Enter tohll of £¢0t~ fn>m $~./,q[ A2, Add 5% sumhal~ (.05 x Al) Subtotal B. Et. tat 25% of Kn~ A1 for Plan C. Invest~ation Fe~ (it ~qui~d) $.~.