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' MARION COUNTY <br /> BUILDING INSPECTION DIVISION *'*" <br /> 3160 LANCASTER DR NE * SUITE C : L <br /> FOR cITy V~.LIDATIONI SALEM OREGON 97305-1398 <br /> ,s,uou '11\ Y <br /> <br />i Please complete all Sections, I th~v~~ C~UNTY I~SXDSm'IAL a COMMERCIAL Q <br /> BUiLDiNG ~NgPECTION uss oF S~uCTUt~: <br /> ,. LOCATION OF INSTALLATION NEW El AIJi~i~TION n ADDITION El I~ELOCATION El <br /> GAS El or ELECTRIC ~ <br /> N~ X Fee = <br /> <br /> Ftoo~ Fum~¢ . $ 6.00 <br /> =ross StreetJDirecdons: Suapended Heate~ $ 6.00 <br /> Wall Heater $ 6.00 <br /> J~ Description: Floor Mounted Hcst~ $ 6.00 <br /> <br /> HI, AT PUMP <br />I~ ARE NON.TRA~SI~RABLE AND EXPIRB IF WORK IS NOT I under 3 Ton $ 6.50 <br /> STARTED WITHIN 180 DAYS OF ISSUANCE OR IF 3Ton and up .. SILO0 <br /> WORK [$ SUS~ED FOR 180 DAYS. Ail[ CONDIT[OlqER <br /> under 3 Ton . $ 6.50 <br />2A. cONTRACTOR INSTALLATION ONLY 3Tonandup SILO0 <br /> <br />  J Commercial Hood and Exhaust $ 4.50 __ <br /> and [hT~ Verbs $ 3,00 <br /> <br /> I Wood Stov~Fir~place -. $ 7.50 <br /> Co~ract~.,s Bom1{ 1~$. [~1o. f~)(~ (.~t~.~-~ ~o Job {%. FmllaCe Ducts (Altecatiou/~xU~is}ou) ~ $7,50 <br /> <br /> On~ Lo~ Lighter $ 7.50 <br /> 2,B. FOK OWIq]~ INSTALLATIONS O~er $ 750 <br /> <br /> Property Ow~ ~leas~ pri~) GAS PIPING SysTEM <br /> [ I~one 4 and up outlets ~er ou~ $ <br /> Mniling Addre~ <br /> <br /> C~t~/5~.ip an apptinme penn~ $ 3.00 <br /> Owne~'a $1gnnture: OTHER (ts s~quir~ by Bt~l~'~, O~c/el) <br /> <br /> 3. PLAN RBt/IBW SECTION <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 />I specifications with this application. <br /> MC 15-41 <br /> REV 8/96 <br /> <br />5. P~/~S <br /> Al. Enter total0f fees from Sec. ~I <br /> A2. Add 5% smeharge(.OS x A l) <br /> ' : ~bt~al <br /> <br />B. Emor25% oflbteAl forPbn Rcview <br />(Al + ,25), if requlred $.-- <br />C. Investigation ]~ee (if mqulmd) <br />D. R¢impection F~ ($25.00) $.-- <br /> TOTAL AMOUNT DUE $.~_.~_~ <br /> <br /> <br />