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FOR CITY VALIDATION <br />Received by: <br />Date: <br /> <br />COMMUNITY DEVELOPMENT CENTER '~_. ~a~-~- r'v n ...... ~ <br /> 285 Church St NE- Room 132 t'l:~(Mll MO:i=l~tl /_ ./ ~._q_q_~ <br /> Salem, OR 97301 Date: MARION COUNTY <br /> <br /> 24Hr Inspection Line: 588-?904 BUILDING INSPECTION <br /> ofl~ ssS-St4? s:oo ~n. - 4:30 V~ Issued by: <br /> FAX: 588-?948 <br /> <br /> I <br /> MECHANICAL PERMIT APPLICATION [ <br /> Please complete all Sections, I through 5 <br /> I <br />1. LOCATION OF INSTALLATION <br /> <br /> wrrm. DA 'S O ,SSUASC <br />'WORK 15 SUSPI~qDED FOR 180 DAYS. <br /> <br /> 2A. COHTRACTOR INSTALLATION ONLY <br /> <br />JConlractor's License No. <br /> <br />2B. FOR OWNER INSTALLATIONS <br /> <br />Marion County does not require a plan review. <br />We will provide plan review ~ervice if you complete <br />Section 5B and submit two (2) sets of plans and <br />specifications with this application. <br /> <br />~ 15-41 <br />Rt~v. 12/94 <br /> <br />4. FEE SCHEDUL~ (comvi~ nnd ente~ total in Al below) <br /> <br /> RESlDEHTIAL~.. COMMERCIAL <br />USB OF STRUCTURE: <br />NEW ~ ALTERATION ~ ADDITION ~t~J~ELOCATION <br />GAS El or ELECTRIC ~l <br /> <br />BASE FEE $10.00 <br /> <br />FORCED AIR FURNACE <br />upto 100,000 BTU $ 6.00 <br />over 100,000 BTU $ 7.00 <br /> <br />Hoer Furnace $ 6.00 <br />Suspended Healer $ 6.00 <br />Wall Heater $ 6.00 <br />Hoer Mounied Healer $ 6.00 <br /> <br />HEAT PUMP <br />under 3 Ton $ 6.50 <br />3 Ton and up $11.00 , <br /> <br />AIR CONDITIONER <br />under 3 Ton $ 6.50 <br />3 Ton and up $11.00 <br /> <br />EvaporativeCooler $ 4.50 <br />Commercial Exhaust System $ 4.50 <br />Commercial Hood and Exhaust $ 4.50 <br />Domestic Range Hood $ 4.50 <br />Domestic Exhaust <br />and D,~er V~ $3.00 <br /> <br />ADDmONAL APPLIANCES <br />GM Waler H~am' $ 7.50 <br />o,- Log Ligh~r $ 7.50 <br />O,- Barbeque $ 7.50 <br />Other $ 7.5O <br /> <br />DA8 PIPINO SYSTEM <br />1-4 outlets (per outlet) ,~"/' $ 2.00 <br />4 and up outl~ (~r outlz0 $ 50 <br /> <br />Appliance Vents not included in <br />an appliance pmnit $ 3.00 <br /> <br />OTItBR (ss required by Buildi~ Offwis0 <br />DWI~LLINO PI~RMIT LABiaL <br /> <br /># of Labels <br /> <br />5. FEES <br /> Al. Enter total of fees from Sec./4 <br /> A2. Add 5% surcharge (.05 x Al) <br /> 8ubt~al <br /> <br /> B. Enter 25% of llne Al for Plan Review <br /> (A 1 + ~5), if required <br /> C. Investigation Fee (if required) <br /> D. Reimpectlon Fee ($25.00) <br /> <br /> TOTAL AMOUNT DUE <br /> Receipt No. <br /> <br />$ ----- <br />$ <br />$ <br /> <br /> <br />