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FO~ CITY VALIDATIONI <br />Received by: <br />Date;,, <br /> <br />MECHANICAL PERMIT APPLICATION <br />P/ease complete ail Sections, I through 5 <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> COMMUNITY DEVELOPMENT CENTER ~-'"MIT <br /> 285 Church St NE Room 1.2 / ,-..::: - <br /> Salem, OR 97301 *'.~,'~ ': ~ " <br /> Date: <br /> <br /> 24 Hr ln~e~tion Line; 588-7904 <br /> <br /> FAX: 588-7948 <br /> <br /> 4. FEE ~I-~DL1'12~ (Complele and eater total iii Al be o~) 0,'7 <br /> <br /> RESIDENTIAL ~ COMMERCIAL <br /> U$I~ OF STRUCTURI~: <br /> NEW El ALTERATION ~, ADDYFION <br /> <br />I. LOCATION OF IIqSTALLATION <br /> <br />I PERMIT$ ARE NON-TRANSFERABLE AND EXPIRI~ 1F WORK I$ NOT <br />STARTED WI[ThIN 180 DAYS OF ISSUANCE OR IF <br />WORK 15 SUSPENDED FOR 180 DAYS, ,' <br /> <br />FOR OWlq~R Ilq'$TALLATION8 <br /> <br />City/Slate/Zip <br /> <br />Agent'a Signature: <br /> <br /> 3. PLANREVIEW SECTION <br /> Marlo; CountY"does not require a plan review, <br /> We will provide plan review service if you complete <br /> Section 5.B and submit two (2) sets of plans and <br /> specificaUons with this application. <br /> <br />MC 15-41 <br /> <br /> GAS )~, or ELECTRIC 71 <br /> No. X <br />BASE <br /> FEE <br /> <br />FORCED AIR FURNACE <br />up lo 100,000 BTU ,_.J__ $ 6.00 <br />over 1~,0~ B~ $ 7.~ <br /> <br />Floor Furnace <br />Suaponded Healer <br />Wail H~t~r .,, $ 6.~ , <br />Floor Mounted Healer $ 6.~ <br /> <br />HEAT PUMP <br />trader 3 Ton $ 6.50 <br />3 Ton and tip $I 1.00 <br /> <br />AIR CONDITIONER <br /> tlnder 3 TO,, I $ 6.50 <br /> <br />ADDITIONAL APPLIANCES <br />Ga* Water Hoatet $ 7,50 <br />Gas Log Lighter $ 7,$0 <br />Gaa Bad~quo $ 7.50 <br /> <br />OA$ PIPINO BY.EM <br /> 14 OU~iet~ (p~r OuSt) ~ $ <br /> <br />~ER (a~ required ~y Buildi~, <br /> <br />DWELLING PERMIT LABEL # of Labels N/C <br /> <br />5. FEES <br /> <br /> A~, Add 5% $~cha~g~ (.05 x A 1) $ J,~ <br /> Subtotal $~, 7~ <br /> <br /> <br />