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02/12/97 09:07 <br /> <br />~503 588 7048 <br /> <br />IFOR CITY VALI[ <br /> R~ceivod by: ~ <br /> Dato: / <br /> <br /> ]i~ kL~L..~)[ \10Ob~ll~l[Y DEVELOPMENT CENTER PERMIT NO: <br /> <br />O~-F" I ~ U I Sal~, OR 97301 <br /> 1 9 ISSZ Dato: <br /> <br /> I 24 hr. [nspectlo~ Line <br /> MARION C0UN~~: ~0"* s~ s,~.~.,:~o~, msu~ by: <br /> <br />MECHANICAL PERMff APPLICATION <br />Please complete all F~ection$, I through 5 <br /> <br />PERMITS ARE N ON-'rRANSFFaPJtBLE AND EXPIEE IF WORK IS NCq' ] <br /> 'STARTED WlTI[I[~ 180 DAY~ OF ISSUANCE OR IF <br /> WORK l$ SUSPENDED FOR 180 DAYS, <br /> <br />2.A. CONTRACTOR IIqSTALLATION ONLY u <br /> <br />co.,.,~es ~i~e So. ~,2 7 2- 0 <br /> I <br />Coemctor's Bmm:l Re8. NO. } Job No. <br /> <br />2B. FOR OWNIIR INSTALLATIONS <br /> <br />l,~iih~ Addt~ Fflo~ <br /> <br />Floor Furnace $ 6.00 <br /> H~t~ $ 6.~ ,,, <br /> <br />HEAT P~P <br />Ton S 6,~ <br />3Ton and up $11.~ <br /> <br /> 3 Ton g $ 6~0 ~ <br /> 3Ton and up T $11~ ~ <br /> <br /> ~g~ H~d $ 4,~ <br /> <br /> D~ Vont~ <br /> ~p~ $ 3.~ ~ <br /> Slov~i~ep~e $ 7.~0 .... <br /> ~c~ (Alt~al~Xtc~ion) $ 7.~ <br /> <br />~D~IO N~ ~PLI~CES <br /> Watar Hca~r $ 7.~ <br /> <br /> $ 7.~ ~ <br /> <br /> PIPINO <br /> <br /> up ~tio~ (~r outlet) S .~ ¢ <br /> <br /> applianc~ p~it $ ~.~ <br /> <br />PERMIT LA~EL //of Labels <br /> <br /> 3, pLANRBVI~W S]~CTION <br /> <br />IMarion County does no~ ~uire ~ pl~ ~view. <br /> We will pr°vi~ pl~ ~vi~w se~ice if you complete <br /> Sec~on 5B and submit ~o (2) se~ ofp~ ~d <br /> sp~ificatio~ wi~ ~s application. <br /> <br />5. FI~E$ <br /> Al. Emir total of fees from S~. #4 <br /> A2.. Add 5% aumh~g~ (.05 x Al) <br /> <br />Subtotal <br /> <br />a. F,u~c2$% of line Al for Plan Review <br /> (Al + .25), if rcquired <br />C. lnveatigation ~ (ifroquit~d) <br />D, R~in~pe~tion F~ ($25,00) <br /> <br /> TOTAL AMoUHT <br />R~¢ipt No. <br /> <br /> <br />