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 P~RMff NO: <br /> Salem, OR 97301 <br /> <br />MECHANICAL PERMIT APPLICATION <br />Please complete all Sections, I through 5 <br /> <br />1. LOCATION OF INSTALLATION <br /> <br /> 24 hr. Inspection Line 373-4427 <br />Office: Phone ~88-S147 8:00am - 4:30pm <br />FAX: S88-7948 <br /> <br /> I <br /> <br />f <br /> <br />PERMITS ARE NON-TRANSFERABLE AND EXPIRE IF WORK IS NOT [ <br />STARTED WITHIN 180 DAYS OF ISSUANCE OR IF <br /> WORK IS SUS PENDF~D FOR 180 DAYS. <br /> <br />2A. COIVI'RACTOR ]NSTALLATION ONLY <br /> <br />Mailing Address <br />Contractor's Lic~ns~ No. <br />Comra¢ior's Board Res. No. lob No. <br /> <br /> 3. PLANRBVIEW SECTION <br />IMarion 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 />Issued by: ~ <br /> <br />4. ~l~]~ ~C~.I~}U'~_.~ (Compl~ ~nd ~ ~1 h Al below) <br /> ~I~ ~ CO~ERCI~ = <br /> U~ OF ~RU~: <br /> ~ ~ ~ON ~ ~D~ON ~ ~TION <br /> GAS ~ ~ ~IC ~ <br /> <br /> No. X F~ - ~m <br />BASE FEE $10.00 <br /> <br />FORCED AIR FURNACE <br />up ~o 100,000 BTU $ 6.00 <br />o~er 100,000 ~ $ 7~)0 <br /> <br />Floor Furnace $ 6.00 <br />Suspended Heatcr $ 6.00 <br />Wall ll~ater $ 6.00 <br />Flo~r Mountcd Heater $ 6.00 <br /> <br />H~AT PUMP <br />under 3 Ton $ 6.50 <br />3 Ton and up SILO0 <br /> <br />AIR CONDITIO~R <br />under 3 Ton $ 6.~0 <br />3 Ton ~nd up $11.00 <br /> <br />Evapora~i~Cooler $ <br />Commercial Exl~ust S~sl~m $ 4.50 <br />Commercial Hood ~nd F~hausi $ 4.~0 <br />Dome~llc Range Hood $ 4.~0 <br />Dom~fic F-a~hawt F~s <br />and I~yer Veins $ 3.00 <br />Fir~ Damper $ 3.00 <br />Wood $1oveffFiroplsco $ <br />Funm¢o Duels (Att~ionf~xt~ion) $ <br />Commercial / Industrial In¢in~ralor $30.~0 <br /> <br /> O~r <br />~AS P1PINO 8Y~I'EM <br /> 14 outleta (per outlet) <br /> and up outlet~ (per cutlet) <br /> <br />$ 7,50 <br />$7.~0 <br />$ 7,50 <br />$7.50 <br /> <br />$ 2.00 <br /> <br />$3.00 -- <br /> <br />5. FliES Al. Enter iolal off~ from Seo./il <br /> A2. Add 5% au~harg~ (.05 x A 1) <br /> <br />B. Enter25% of lin=Al for Plan Review <br /> (Al + .25), if required <br />C. Investigation Fee (if required) <br />D. Reirmpeotion Fee ($25.00) <br /> <br /> TOTAL AMOUNT DUE <br />Receipt No. <br /> <br /> <br />