Laserfiche WebLink
FOR CITY VALIDATION <br />Received by:, <br />Date: <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> COMMUNITY DEVELOPMENT CENTER <br /> 285 Church St NE · Room 132 PERMIT NO: <br /> Salem, OR 97301 <br /> Date: <br /> <br /> . I~/k/ ~ 0 4~tE SCHBDULI~ (ComH~te ~.d emer tota~ in A] below) <br /> <br /> MARION )OUNTY P~Sms~rn~L ~ COMM~-RC~AL 0 <br /> BUILDING ~P~",F~r~ STRucru~: <br /> --~1~ ALTERATION Q ADDITION gl RELOCATION I~ <br /> GAS ~ or ELECTRIC El <br /> No. X F=e = Sum <br /> BASE FEE $10.00 <br /> <br /> MECHANICAL PERMIT APPLICATION <br /> Please complete all Sections, I through 5 <br /> <br />1. LOCATION OF INSTALLATION <br /> <br />IobAddress 705 [~11T'Oh ,~i'. <br />ci~ Aumsvill~, Oragon q7325 <br />~.,t~ owner ~b Bradt:~lry I rhon~ <br /> <br />Cr~s S~ire~om: 7th St. <br /> <br />74q-Bq~ 2 <br /> <br />Job Description: <br /> <br />PERMITS ARE NON-TRANSFERABLE AHD EXPIRE IF WORK IS NOT I <br /> STARTED WITHIN 180 DAYS OF ISSUANCE OR IF <br /> WORK IS SUSPENDED FOR 180 DAYS. <br /> <br />2A. CONTRACTOR INSTALLATION ONLY <br />Contractor Salem Htg. & Sht. Mt.I 581-1536 <br /> <br />MailingAddm~, P.O. I~x 12005, Salem, OR 9370 <br /> <br />Conwactor's Lic~ns~ No. <br /> <br />Contcactor's Board Reg. No, 1505 [ ~ob No. <br /> <br />2B. FOR OWNBR INSTALLATIONS <br />PropeWJ Owner (pleasepd~t) <br />Mailing Addreas Phone <br />City/StatedZip <br />Owner's Signature: <br /> <br />Agent's Signature: <br /> <br />FORCED AIR FURNACE <br />up to 100,000 BTU t $ 6.00 <br />over 100,000 BTU $ 7.00 -- <br /> <br />FloorFumace $ 6.00 -- <br />Suspended Heater $ 6.00 <br />Wall Heater $ 6.00 -- <br />Floor Mounted Heater $ 6.00 -- <br /> <br />6.00 <br /> <br />HEAT PUMP <br /> under 3 Ton <br /> 3 Ton andup <br /> <br />AIR CONDITIONER <br />under 3 Ton 1 <br />3 Ton and up <br /> <br />EvaporaliveCooler <br />Commercial Exhaust System <br />Commercial Hood and Exhaust <br />Demotic Range Hood <br />Domestic Exhaust Fans <br /> and D~er Vents <br />Fire Damper <br />Wood StovedFireplae~ <br />Furnace Ducts (Alt er atiordExt ensioa) <br /> <br /> 1 <br /> <br />$ 6.50 -- <br />$11.00 -- <br /> <br />$ 6.~o 6.50 <br />$11.00 -- <br /> <br />$4.50 __ <br />$4.50 <br />$4,50 -- <br />$4.50 -- <br /> <br />$ 3.00 -- <br />$ 3.00 <br />$7.50 <br />$7.50 <br />$30.00 <br /> <br />$7.50 -- <br />$7.50 -- <br />$7.5o __ <br />$ 7.50 __ <br /> <br />GAS PIPING SYSTEM <br />1~' outlets (per outlet) $ 2.00--2 · O0 <br />4 and up outlets (per cutlet) $ .50 -- <br /> <br />Appliance Vents not included in <br />an appliance permit $ 3.00 -- <br /> <br />OTHER (as required by B~il~t~g Ol~ciaO <br />DWELLING PERMIT LABEL # of Labels N/C <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 />REV 8/96 <br /> <br />5. FEES <br />Al. EntsrtotsloffeeafromSec.#4 $ 2/+.50 <br />A2. Add 5% sm~harge (.05 x Al) S~-L.23 <br />~ubtolal <br /> <br /> B. ~ter25% ofl~cAl for Pl~Rcvicw <br /> (Al + .25), if gq~d <br /> C. ~veatiga~on Fee (if~u~d) <br /> D. Reinspeetion F~ ($25.~) $ <br /> <br /> T~ ~O~ D~ <br /> Receipt No. <br /> <br />s__25_._Z3 <br /> <br /> <br />