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MARION COUNTY BUILDING INSPECTION <br /> COMMUNITY DEYELOPMENT CENTER pi="' · <br /> 285 Church St NE · r~w J s~J: <br /> FOR CITY VALIDATION . _=.(,.~R~?~ <br /> <br /> ] <br /> <br />I MECHANICAL PERMffAPPLICATION ] uARl~ <br />Please complete all 8ectlons, I through ,5 "' DII~ [HSpF..C'TTDH <br /> I ~U%L X~aDm~ZAL ~ COM~CC~ C3 <br /> <br />1. LOCATION OF INSTALLATION <br /> <br />PERIvffr8 ARE NON-TRANSFERABLE AND EX P~.E IF WORK IS NOT <br /> STARTED V~rrH1N 180 DAYS OF ISSUANCE OR IF <br /> WORK IS SUSPENDED FOR 180 DAYS. <br /> <br />2A. CONTRACTOR INflTALLATION ONLY <br /> <br />ConUac~or's Liocme No. ,~ <br />Conlractot'. Board Reg. No. ;/~'~ ] Job No. <br /> <br />FOR OWHRR INSTALLATION8 ~ <br /> <br />Prope~ Owner (pkM~ priot) <br /> <br />Mniling Addr~n Phone <br /> <br />City/State/Zip <br /> <br />Ov~Fs SiSnatm'e: <br /> <br />A&,~'s Si~mre: <br /> <br />U~ OF STRUCTURE: <br />NEW O ALTERATION J~.ADDITION Q R[R.OCATION 1~ <br />GAS ,~l or I~.I.f!CTRIC ~1 <br /> <br /> No. X Fee m ~m <br />BASE FEE $10.00 <br /> <br /> ~ 1~,~ ~ S 7.~ <br /> <br />~ce S 6.~ <br />Sm~d H0at~ $ ~ <br />W~ ~t~ $ <br /> <br />HEAT PUMp <br />under 3 Ton $ 6.50 <br />3 Ton and up <br /> <br />AIR COI~IITIONER <br />under 3 Ton $ 6.50 <br />3Ton~td up SILO0 <br /> <br />EvapomtiveCeoler $ 4.50 <br />Commercial Exhaust System $ 4.~0 <br />Conunc~ial Hood and Exhaust $ 4.~) <br />Domestic Range Hood $ 4.~0 <br />Domestic Exhm~ <br />and l~y~ Vents $ 3.00 <br />F'u~ Damper $ 3,00 <br />Wood Stove/Fkoplace $ 7.50 <br />Furnace Duct~ (Aitc~xtcmion) S 7=,~0 <br />Commercial / Indus*mil In¢incra~' ~30.00 <br /> <br /> Gm Water H~a~ S 7.50 <br /> Gna Log Lighte~ $ 7.50 <br /> <br />GA8 PIPINO SYSTEM <br /> 1-4 outlets (p~ outlet) <br /> 4 and up outbta ~ outlet) <br /> <br />Applinnce Ve~ta not included in <br />~'~ npplinn~ pennlt <br /> <br />DWELLING lq~RMIT LABBL # of I.,al)oh <br /> <br />S 24)0 <br />$ ~ <br /> <br />$3.00 <br /> <br /> 3. PLANRBVIB~ SBCTION <br /> <br /> Madon County does not require a plan review. <br />I We will provide plan review service if you Complete <br />I Section 5B and submit two (2) set~ of plans and <br /> specificatins wJth this application. <br /> <br />MC 15-41 <br /> <br /> <br />