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FOR CITY VALIDAT~ <br /> <br />Received by: <br />Date: <br /> <br />a~~.BvUI LDLNG INSPECTION <br /> ELOPMENT CENTER ........ q'7,.e <br />' ~ 285~1~St NE- Room 132 HlaHMli FILl. <br /> <br />APE 1 q 1997 ~m, OR97301 Date: <br /> <br /> 24 hr. Inspection Line 373-4427 <br />~IARION CO~l~Xyehone ~s-5~4~ 8:00.,.- 4:30pm <br /> <br />Issued by: <br /> <br />MECHANICAL PERMIT APPLICATION <br />Please complete all Sections, I through $ <br /> <br />BUILDING INSPECTION ~: 588-7948 <br /> <br />1. LOCATION OF INS'fALLATION <br /> <br />l Job Address <br /> <br />PERMITS ARE NON-TRANSFERABLE AND EXPIRE IF WORK IS NOT <br /> STAR'IED WITHIN 180 DAYS OF ISSUANCE OR IF <br /> WORK IS SUSPENDED FOR 180 DAYS. <br /> <br />2A. CONTRACTOR INSTALLATION ONLY <br /> <br />Contractor's Boalxl Reg. No~ ~ Job No. <br />Contractor's Signature: ~ , ~ ~ <br /> / (3' <br /> <br /> 2B. FOR OWNER II~ISTALLATIONS <br /> <br /> l~op~rty Owner ~lea~pri~) <br /> <br /> ~ty/S~t~p <br /> <br /> 3. PL~ ~EW S~CTION <br />Marion Co~ not require a plan <br /> does <br /> We will provide pl~ review se~ice if you complete <br /> Sec~on 5B and submit ~o (2) sets of pla~ and <br /> specifica~ons wi~ ~is application. <br /> <br />4. FEB SCHBDULti (Complete and enter total in Al below) <br /> RES1DEHTIAL~ COMMERCIAL ~-I <br /> USE OF STRUCTURE: <br /> NEW [3 ALTERATION Q ADDITION Q RELOCATION O <br /> GAS O or ELECTRIC ~1 <br /> No. X Fee m Sum <br />BASE FEE $10.00 <br /> <br />FORCED AIR FURNACE <br />up to 100,000 BTU $ 6.00 -- <br />over 100,000 BTU $ 7.00 <br /> <br />Hoer Furnace $ 6.00 -- <br />Suspended Heater $ 6.00 -- <br />Wall Heater $ 6.00 -- <br />Floor Mounted Heater $ 6.00 -- <br /> <br />HEAT PUMP <br /> under 3 Ton <br /> 3 Ton and up <br /> <br />AIR CONDITIONER <br /> under 3 Ton <br /> 3 Ton mad up <br /> <br />EvaporativeCooler <br />Commercial Exhaust System <br />Co~mnercial Hood and Exhaust <br />Domestic Rm~ge Hood <br />Domestic Exhaust Fans <br /> and Dryer Vents <br />Fire Damper <br />Wood Stove~Fir~place <br />Furnace Ducts (Alteration/Extension) <br />Comtnercial / Industrial Incinerator <br /> <br />s 6.50 <br />$11.00 <br /> <br />$ 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 />$7.5O -- <br />$7.50 <br />$30.00 -- <br /> <br />ADDITIONAL APPLIANCES <br /> Gas Water H~ter <br /> Gas Log Lighter <br /> Gas Barbeque <br /> Other <br /> <br />$ 7.50 -- <br />$ 7.50 -- <br />$ 7.50 <br />$ 7.50 __ <br /> <br />GAS PIPING SYSTEM <br /> 14 outlets (per outlet) <br /> 4 and up outlels (per oufle0 <br /> <br />Appliance Vents not included in <br />an appliance permit <br /> <br />OTHER (as required by Buil~ng Official) <br /> <br />DWELLING PERMIT LABEL # of Labels <br /> <br />$ 2.00 __ <br />$ .50 __ <br /> <br />$ 3.00 -- <br /> <br />NIC <br /> <br />5. FEES <br /> Al. Enter total of fees from Sec, #4 <br /> A2. Add 5% surcharge (.05 x Al) <br /> Subtotal <br /> <br /> B. ~nter 25% of line A1 for Plan Review <br /> (Al + .25), if required <br /> C. Investigation Fcc (if required) <br /> D. Reinspcction Fee ($25.00) <br /> <br /> TOTAL AMOUNT DUE <br /> Receipt No. <br /> <br />$ <br />$ <br />$ <br /> <br /> <br />