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COAIMUNfFY DEVELOPMENT CEN'II~ <br />] FOR CITY VALIDATION ] 285 Church St NE- ~oom 132 <br /> <br />[ Received by: [ Salem, OR 97301 Data: <br />[Date: <br /> <br />MECHANICAL PERMIT APPLIC"~I(~R[ 1 5 1997 <br /> <br />L LOCATION OF InsTALLATION BUILDING INSPECTI <br /> <br />PERMITS ARE NON-TRANSI~RABLE AND ~ IF WORK IS NOT <br /> STARTED WITHIN 180 DAYS OF ISSUANC~ OR IF <br /> WOP, K IS SUSPENDED FOR 180 DAYS. <br /> <br />2A. CONTRACTOR INSTALLATION ONLY <br /> <br />Omlra¢~or', Bo~dRos. Ho. · 53 { lobNo. <br /> <br />2B. FOR OWNI~ INSTALLATIONS <br /> <br />Property Owner (pl~se pri~t) <br /> <br />Mnili~ A~ <br /> <br />Ci~lS~ <br /> <br />A~l's Si~mm: <br /> <br /> US~ OF a-rKUCTURE: , <br /> NEW [2 ~LTF. RATION ~ADDITION I~1 RELOCATION ~ <br /> OAS ~or ELECTRIC [2 <br /> <br />BAS~ Ft~ $10.60 <br /> <br />FORCED AIR FURNACE <br />up~o 100,000 BTU $ 6.00 <br />ov~ 1~0.000 BTU $ 7~0 __ <br /> <br />X~or Furnace $ 6.00 <br />Suspended lle~r $ 6.00 <br />Wall Heater $ 6.00 <br />Floor ~ Heater $ 6.00 <br /> <br />HEAT PUMP <br />und~ 3 Ton $ 6.50 <br />3 Ton and up SILO0 <br /> <br />AIR COI~TIO~R <br />ruder 3 Ton $ 6.50 <br />3Tin, md up SILO0 <br /> <br />Evq~tiveCooler $ 4.50 -- <br />Cemmercial Exhaust System $ 4.50 __ <br />Commercial Hood and Exhaust $ 4.50 __ <br />Domestic Range Hood $ 4.50 __ <br />Domeatic Exha~s~ ~ans <br />and Drya'Ven~ $3.00 <br />Fire Damper $ 3.00 <br />Wood S~o~e/Firepince $ 7.50 __ <br />Furnace Ducts (/dteratiodExteminn) $ 7.50 -- <br /> <br />OAS PIPING SYffFEM <br /> I-4 oufle~ (per oufle0 <br /> 4 md ~ omJeu (~ ~) <br /> <br /> ~ ~li~e ~il <br /> <br />D~LL~ PE~ L~EL ~of~ <br /> <br />S 2.OO .~,OO <br />S 5O <br /> <br /> 3. PLAN RB¥1~'fi' SECTION <br />iMarion County does not require a plan review. <br /> We will provide plan review service if you complete <br /> Section 5B and subm!t two (2) s. ets of plato and <br /> specifications with this application. <br />IV~ 15-41 <br />I~,v. I.?N4 <br /> <br />5. FEBS Al. Fmt~r Ioml of f~ from S~¢. 114 <br /> A2. Add 5% su~h~ (.05 x Al) <br /> <br />B, Eater 25% of line A 1 for Plan Review <br /> (A 1 + .25), if r~quimd <br />C. ]~veJli~ttinn F~ (ifrequlred) <br />D. R~fon Fe~ ($25.00) <br /> <br /> TOTAL AMOUNT DUE <br /> <br /> <br />