Laserfiche WebLink
Received by:. <br />Date: <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> COMMUNITY DEVELOPMENT CENTER PERMIT NO: <br /> 285 Church St NE · Room 132 <br /> Salem, OR 97301 <br /> <br /> 24 hr. Inspection Line 373..4427 <br />Office: Phone 588-5147 8:00am - 4:30pm <br />FAX: 588-7948 <br /> <br />Date: <br /> <br />Issued by: <br /> <br /> MECHANICAL PERMIT APPLICATION <br /> Please complete all Sections, I through 5 <br /> <br />1. LOCATION OF IHSTALLATION <br /> <br /> 945 Olney Rd. <br />Job Address <br /> <br />Acunsv%lle, ORegon <br /> <br /> Blazer Industries [Phones 74q-gqfi2 <br /> <br />Cross Street~Directiom: A~unsville Hi~hwav <br /> <br />Job Descrip6on: <br /> <br />WORK IS SUSPENDED FOR 180 DAYS. <br /> <br />2A. COHTRACTOR INSTALLATION ONLY <br />ContraclorSal~fl Htg. & Sht. Mtl/I Phone 581-1536 <br /> <br />MailingAddmsa P.O. Box 12005, Salem, Or <br /> <br />Contractor's License No. <br />Con,actor's Board Reg. No. 150 5 Job No. <br /> <br />ConWa etor's Signature: ~ ~ <br /> <br />2B. FOR OWNER INSTALLATIONS <br /> <br /> Peop~fly Owner (pleas~ pri~t) <br /> <br /> 3. PLAN REVIEW S~CTION <br /> <br /> Marion 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 /> t~ #97-01992 <br /> <br />4. FEE SCHEDULE (Complete and enter total in A1 below) <br /> <br /> RESIDENTIAL [~ COMMERCIAL I-il <br /> USE OF STRUCTURE: <br /> NEW rn ALTERATION UI ADDITION 12 RELOCATION <br /> GAS ~ or ELECTRIC C1 <br /> No. X Feo = 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 />FloorFumace $ 6.00 -- <br />Suspended Heater ~ $ 6.00 <br />Wall Heater $ 6.00 -- <br />Floor Mounled Heater $ 6.00 -- <br /> <br />1 2.00 <br /> <br />HEAT pUMP <br />under 3 Ton $ 6.50 <br />3Tonand up $11.00 <br /> <br />AIR COHDITIOI~R <br />under 3 Ton $ 6.50 -- <br />3 Ton and up $11.00 -- <br /> <br />EvaporativeCooler $ 4.50 -- <br />Commercial Exhaust System $ 4.50 -- <br />Commercial Hood and Exhaust $ 4,50 -- <br />Domestic Range Hood $ 4.50 <br />Domeslic Exhaust Fans <br />and D~Te~ Vents $ 3.00 -- <br />Fire Damper $ 3.00 <br />Wood Stove/Fireplace $ 7.50 <br />Furnace Duets (Alteration/Extension) $ 7.50 <br />Cofiunercial / Industsial Incinerator $~0.00 -- <br /> <br />ADDITIONAL APPLIANCES <br />Gas Water Heater $ 7.50 -- <br /> Gas Log Lighter $ 7.50 <br /> Gas Badoeque $ 7.50 -- <br /> Other $ 7.50 -- <br /> <br />GAS PIPING SYSTEM <br /> 14 oudets (per outlet) <br /> 4 and up outlets (per outle0 <br /> <br />Appliance Vents not iocluded in <br />~ appliance permit <br /> <br />OTHER (as required by Building O~cial) <br /> <br />DWELLING PERMIT LABEL # of Labels <br /> <br />$ 2.00 -- <br />$ 30 __ <br /> <br />$ 3.00 -- <br /> <br />N/C <br /> <br />FEES <br />A I. Enter total of fees from Sec. #4 <br />A2, AddS% surcharge (,05 x Al) <br /> <br />Subtotal <br /> <br />s <br /> <br />$ <br /> <br />B. Enter 25% of line A1 for Plan Review <br /> (Al + ,25), if required <br />C, Investigation Fee (if required) <br />D. Reinspection Fee ($25.00) <br /> <br /> TOTAL AMOUNT DUE <br />Receipt No. <br /> <br /> 12.60 <br />%__ <br /> <br /> <br />