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FOR CITY VALIDATION <br />Received by: <br />Date: <br /> <br />MECHANICAL PERMff APPLICATION <br />Please complete all ~ections, I through 5 <br /> <br />I. LOCATION OF INSTALLATION <br /> <br /> 285 Church St NE' Room 132 PERMIT NQ/.4 .. <br /> <br />Offr.,e: 588-5147 8'00a.m -4'30p.m. I~sueQ Dy: <br />VAX: saa-794a ' <br /> <br /> 4. I~R SCH]~UL~ (Complota and eat~ totalia A1 b~low} <br /> R~$IDBNTIAL,~ COMMF, RCIAL <br /> USE OF STRUCTURe: <br /> NEW O_ALTERATION O ADDITIDN <br /> GAS/~' or ELECTRIC [~ <br /> No. X Fee ~ Sum <br /> BASF. FE]~ $10.00 <br /> <br />IPERMITS ARE AHD EXPIR~ IF WORK IS NOT <br /> NON-TRANSFERABLE <br /> STARTED WITHIN 1~0 DAYS OF L~SUAN C~ OR IF <br /> WORK IS SUSPF-NDED FOR 180 DAYS. <br /> 2A. CONTRACTOR INSTALLATION ONLY <br /> <br />2B. FOR OWIq~R INSTALLATIONS <br /> <br />l~opmy Owner ~o/et~ priat) <br /> <br />Mailing Adders [ ~ <br /> <br />City/State/Zip <br /> <br />Own~'s Signatu~: <br /> <br />FORCED AIR FURNACE <br />up to 100,000 BTU $ 6.00 ,, ,, <br />over I00,000 BTU $'?.OO~ ' '~ <br /> <br />Floor Furnace $ 6.00 <br />SuapendedHeater ~ ~$ 6.00 <br />Wall Heater ,, 6.00 <br />Floor Mounted Healer $ 6.00 <br /> <br />HEAT PUMP <br /> under 3 Ton <br /> 3 Ton and up <br /> <br />MR CONDITIONER <br /> under 3 Ton <br /> 3Tonand up <br /> <br />Evaporativ~ool~ <br /> <br />Furnace Duets (Aiteration/Ext~i~n) <br /> <br />$ 6.50 <br />SILO0 <br /> <br />$ 6.50 <br />SILO0 <br /> <br />$ 4.5O <br />$4.5O <br />$4.50 <br />$4.50 <br /> <br />$ 3.00 <br />$ a.0o <br />$7.50 <br />$7.50 <br />$.30.00 <br /> <br />Gas Log LigMer <br /> <br />$ 7.5O <br />$ 7.50 <br />$ 7.5O <br />$7.50 <br /> <br />GAS PIPING SY~TliM <br /> 1-4 outlets (per ouaet) <br /> 4 and up outlets (per outlet) <br /> <br />Appliance Vents n~t inoluded in <br />an appliance permit <br /> <br />OTHER las requited by Buildi~ Ol~cial) <br /> <br />DWELLING PERMIT LABEL # of Labols <br /> <br />$2.00 <br />S .5O <br /> <br />$ 3.00 <br /> <br />N/C <br /> <br /> 3. PLANRBVIEW SBCTION <br /> <br /> Marion County does not require a plan review. <br />I <br />We will provide plan review service if you complete <br />I Section 5B and ~ubmit two (2) sets of plarm and <br />I specifications with this application. <br />MC 15-41 <br /> <br />5. FBBS <br /> A I. ~a~r totsl of fzes from Se~. ~4 <br /> A2. Add 5% $urclmrg~ 605 x Al) <br /> Subtotal <br /> <br /> B, Eater 25% of lin~ Al for Plan Review <br /> (Al + .25), if required <br /> C. Investigation Fo~ (if requited) <br /> D. Roinspection Fee ($25.00) <br /> <br /> TOTAL AMOUNT DUI~ <br /> <br />$ <br />$ <br />$ <br /> <br />s <br /> <br /> <br />