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FOR CITY VALIDATION <br />Reaeived by:, <br />Date: <br /> <br />MECHANICAL PERMIT APPLICATION <br /> Please complete all Sections, I through 5 <br /> <br />,. LOCATION OF INSTALLATiON <br /> <br /> COIJNTY BUiLDING INSPECTION <br />MARION <br /> COMMUNITY DEVELOPMENT CENTER <br /> ~$ Church, St NE · Koom 132 <br /> Sale,m, OR 97301 <br /> <br /> 24 Hr Insp~tton Linc: 588-?904 <br /> Offw~e: 588-51~47 8:O0a.m.-4:3Op.m. [$aund by: <br /> FA~: 588-7943 <br /> <br /> 4- FE~ ~CH]~DUL~ (CCauplut¢ and ent~ total i~ Al below) <br /> <br /> RH$IDENTIAL ~1 COMMEKCIAL ~l <br /> USS OP STRUCTWRP~: <br /> N~W (~ALTF_.RA'rION D ADDITION E] RELOCATION O <br /> GAS <br /> ~-,~kvr ELECTRIC [3 ~ X F~ ~ S~m <br /> BA~E FEE~ <br /> <br />PERMITS AILE NON-TRANSFI~P, AELE AND I~XPIRE I1~ WORK I5 NOT <br /> ~AR~ ~IN 1~ DAYS ~ I~$U~ OR ~ <br /> WO~ IS gU8~D~ FOR 180 DAYS, <br /> <br />2A. CO~ACTOR,~LATION 0~ ..... <br /> <br />2B. FOR OWNER INSTALLATIONS <br />[~rop~ty Owner (pl~a~ print) <br /> <br />Mailing Ad&e. aa Phone <br /> <br />CitylStatdzip <br /> <br />Agent's Signature: <br /> <br />3. PLANRBVIEW SECTION <br /> <br /> Vla£ion County does nm require a plan review. <br />~Ve will provide plan review service if you complete <br />Section 53 and submit two (2) sets of plan~ and <br />specifications with this application. <br /> lC 15-41 <br /> <br />Date: <br /> <br />FORCI~D AIR FURNACE / <br />up to 100,000 BT~ $ 6.00 <br />Over 100,000 B~J $ 7,00 <br /> <br />I~ioor F-~ma~ $ 6.00 <br />Su~l~nded Heater $ 6.60 __ <br />Wall Heater $ 6,00 <br />Floor Mounted H~alcr $ 6,60 <br /> <br />DWltLLINO IatIRMIT LABIIL # of Labels .NIC <br /> <br />5. FEES <br />Al. Enter ~otal of£~s from Sec, ~ $_ __ <br />A2, Add 5% ~ha~ (,05 x Al) $.~ <br /> 8nbt~al $ ,, <br /> <br /> (Al * ,25), if ~qo~d $_~ <br /> C, l~v~6gat~n ~c (if ~ui~) $,, <br /> <br />HEAT PUMP <br />under 3 Ton $ 6.50 -- <br />3 Ton sad up St t.~0 ~ <br /> <br />AIR CONDITIONER <br />under 3 Ton $ 6,50 <br />3 Ton and up ~ $11,00 -- <br /> <br />EvapocatlvcCe, olat ~ $ 4,50 <br />C0iumgrcla[ F~xlta{aat Sy~tatu. ~ $ 4,50 <br />Commeroiul Hood and Exhaust $ 4.50 <br />Domesfi~ R~ge Hood ~ $ 4.50 .... <br /> <br />and Do, er Vents __ $ <br />Fi~ Damper ~ $ 3.00 ., <br />WOOd Stove./Fh~$placo ~ $ 7,~O -- <br />FuCoa¢~ Du~t~ (Alt~rat{oWEX~c~ioa) $ ?.~0 .., <br />Co~n~r~ial / lnduatlial I~¢inerator ~ $~0,00 <br /> <br />ADDITIONAL APPLIANCI/8 <br />Ga~ Wot~r Haa~r $ ?30 <br />Ga~ Log Llght~r ~. $ 7.$0 <br />O~ Ba~lw4u~ ~ $ 7,50 <br />Otl~r ., $ 7.50 <br /> <br /> <br />