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FOR CITY VALIDATION <br />'Received by:. <br />Dat~: <br /> <br />MARION COUNT'Y <br /> COMMUNITY E' EVELOPMENT CENTER <br /> 285 Churcli St NE · Room 132 <br /> Shlem, OR 97301 <br /> <br /> BUILDING INSPECTION <br /> <br /> PERMIT NO: <br /> <br /> Date: <br />24 Hr I~sp~ion Line: 588-7904 <br />Off'tc.~ 558-5J47 8:00a_m.-4:30p,m. ]sskled by: <br />FAX: 588-7945 <br /> <br /> MECHANICAL PERMIT APPLICATION <br /> P/ease complete all Sections, I through ~ ,, <br /> <br />1. LOCATION OF IiXISTALLATION <br /> <br />PERMIT~ ARE NON-TRANSFERABLE AND EXPIRE IF WORK IS NOT: <br /> STARTED WITHIN lgO DAYS OF ISSUANCE OR IF <br /> WORI< IS SUSPENDED FOR 180 DAYS, <br /> <br />2A. CONTRACTOR IlqSTALLATION ONLY <br /> " / <br /> <br />Conl~ac[or's License No, <br /> <br />Mailing Addr~s <br /> <br />City/Sta~,7.ip <br /> <br />3. PLAN REVIEW SECTION <br /> <br /> Marion County does not require a plan review. <br /> We 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 15-41 <br />Rev. 12/~4 <br /> <br /> FEE SCHEDULIi (Compl~l~ mid enter total [,~ Al below) <br /> RI~ SIDENTIAL.]~['/ COMMERCIAL ~1 <br />USE OF STRUCTURE: <br />NEW [] ALTERATION ~ADDiTION ~' RELOCATION <br /> <br />GAS I~ or ELECTRIC <br /> <br />BASE FEE <br /> <br />No. X Pw ~ <br /> <br />FORCt/D AIR FURNAC£ <br />up to 100,000 BTU $ 6,00 <br />owr 100,000 BTU $ 7.00 __ <br /> <br />Floor F~mace $ 6,00 <br />Susl~nded Healer $ 6.(X) __ <br />Wall H~ter $ 6,(X) <br />FlootMounted Healer $ 6.00 <br /> <br />HEAT PUMP <br />under 3 Ton $ 6.50 <br />3 Ton and up $11.00 __ <br /> <br />AIR CONDITIONI~R <br /> under 3 Ton $ 6.50 <br /> <br />Commercial Hood and ~xhaust $ 4.50 <br /> and Dl2/~r V~nla $ 3,00 __ <br /> <br />Fire Damper <br /> <br />Furnace Du~t~ (Alt~ration/ExtenMon) <br />Commemial ! Inthm~aI ln¢inorator <br /> <br />$ 7,50 <br />$30,00 <br /> <br />ADDITIONAL APPLIANCIgS <br />Gas Water Heater $ 7.50 .......... <br />O~s Log Lighter $ 7,50 __ <br />Oas Barbeque $ 7.50 <br />Other $ 7,50 <br /> <br />GAS PiPiNG SYSTEM <br /> 1-4 oull~ls (puc outlet) <br /> 4 and up outlet~ (~r outlet) <br /> <br />OTHER (ss tuquired by B~I~ O~oiaO <br /> <br />DWgLLING PERM~ L~EL g of ~bela <br /> <br />2.00 <br /> 30 <br /> <br />$ 3,00 <br /> <br />5. FBI, S <br />Al. ]gntcr total ol'l~es from See, #4 $___ <br />A2. Add 5% sureharg~ (.05 x Al) $ ..... <br /> Subtotal $ <br /> <br /> D. Reimpc¢tion F~ ($25.~) <br /> <br /> TOT~ ~OU~ DUE <br /> <br /> <br />