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FOR CITY VALIDATION <br />Received by:. <br />Date: <br /> <br />MARION COUNTY <br />BUILDING INSPECTION DIVISION <br />3150 LANCASTER DR NE- SUITE C <br />SALEM OREGON 97305-1398 <br /> <br /> 24 Hr Inq~:tion Lin~ 588-7904 <br />Office: $88-5147 8:00 a.m. - 4:30p.m. <br /> <br />PERMIT NO: <br /> <br />Date: <br /> <br />Issued by: <br /> <br /> MECHANICAL PERMIT A PPLICATI ]~ ~]~OLE (Complete and ente¢ Iotal ~ A1 below) <br /> ~e~e complete ~1 ~tions, I throug~ n ~ -~ '~ ~] ~ ~ <br /> '1 U~ , ~ ~ I~?~.T~I~I~:~ COMMERCI~~ <br />1. LOCA~ON OF ~LA~ON ....... J .~ O AL~TION ~ ~DmON O ~OCATION <br /> <br />PERMITS AffA~£L-TR~iN iFER~Bi)L~ys%DFI~sPu%LWoOR :~IS NOT <br /> WORK IS SDS~-NDF-.D FOR 180 D^¥S. <br /> <br />ZA. CONTRACTOR ]~IffYALLAT]ON O~¥ <br /> <br />I~iling Addr~ <br />Contr~¢tor'~ Board Rqt. No. I lob No. <br /> <br />2B. FOR OWNBR INSTALLATIONS <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 />A~C 15-4l <br />R~v. 12/94 <br /> <br /> np to 100,000 BTU $ 6.00 <br /> over 100,000 BTU $ 7.00 -- <br /> <br />Floor Furnace $ 6.00 -- <br />Suspended Heater $ 6.00 -- <br />Wall Heater $ 6.00 -- <br />FloorMoun!~ed Heater $ 6.00 -- <br /> <br />HEAT PUMP <br />under 3 Ton $ 6.50 -- <br />3 Ton and up SILO0 -- <br /> <br />AIR CONDITIONER <br />under 3 Ton $ 6.50 -- <br />3 Ton and up $11,00 -- <br /> <br />EvapocativeCoolcr $ 4.50 -- <br />Commercial Exhaust System $ 4.50 -- <br />Commercial Hood and F2du~ust $ 4.50 -- <br />Domestic Range Hood $ 4.50 __ <br />Domestic Exhaust Fans <br />and Dryer Vents $ 3.00 -- <br />l~ir~ r $ 3,00 <br /> <br />CommeRcial / ]adusttial Incinerator $30.00 -- <br /> <br />ADDITIONAL APPLIANCES <br />Gm Waler Heater $ 7.50 -- <br />Gas Log Lighter $ 7.50 -- <br />Gas Bad)eque $ 7,50 __ <br />Other $ 7.50 -- <br /> <br />GAS PIPIND SYSTEM <br />1~I outlets (p~routle0 $ ZOO -- <br />4 and up outlets (per outlet) $ .50 -- <br /> <br />ApplLance Vents not included in <br />an appliancepemfit $ 3,00 -- <br /> <br />OTHER (as requiwd by B~l~qg Of~cial) <br />DWELLINO PERMIT LABEL* #of Labeb N/C <br /> <br />5. FEES Al. Enicr totalof f~e~ from Sec. #4 <br /> A2. Add 5% sLwcharge (.05 x Al) <br /> <br />Subte~l <br /> <br />B. Enter25% of lineAl for PlanRevicw <br />(Al + 25), ifgquired $ <br />C. Laveatiga6on Fcc (if required) $ <br />D. Reinspection Fee ($25.00) $ <br /> TOTAL AMOUNT DUE : IC~..~ <br />Receipt No, <br /> <br /> <br />