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FOR CITY VALIDATION <br />Received by:., <br />Date: ' ' <br /> <br />MARION COUI~Y BUILDING INSPECTION <br /> COMMUNITY DEVELOPMENT CENTER <br /> 285 Church St NE · Room 132 PERMIT NO: <br /> Salem, OR 97301 <br /> Date: <br /> <br />IMECHANICAL PERMff APPLICAfl1[II~" / <br /> PleasocomPletoallSoctlon$,I throu~g - 1 ::: <br /> <br />24 ha Inspection Line 373-4427 <br /> .~0pm ISSUe(J by; <br /> <br /> $.~ SCH~DUL~ (Complete ~d ~t~ ~1 ~ Al below) <br /> ~SIDE~I~ ~ COMMERCI~ ~ <br /> U~ OF ~RU~:' <br /> NEW O AL~RA~ON O ~DffION~CA~ONO <br /> 0~AS ~ or ~E~IC O <br /> No. X ~m ~ Sum <br /> B~E FEE $1~ <br /> <br /> PERMITS ARE NON-TRANSFERABLE AND EXPIRE IF WORK IS NOT <br /> STARTED WITHIN 180 DAYS OF ISSUANCE OR IF <br /> WORK IS SUSPF. NDED FOR 180 DAYS. <br /> <br /> 2A. CtNT/~ACTOR INSTALLATION ONLY <br /> <br />I Contractor's License No. <br /> <br />2,B. FOR OWHI~R I}tAS~ALLATION$ <br />Propeay Owner (pier.prim) <br /> <br />MaillngAddre~s <br /> <br />City/State/Zip <br /> <br />FOILCED AIR FURNACE <br />up to I00,000 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 />Floor Mounted Heater $ 6.00 <br /> <br />HEAT PUMP <br />under 3 Ton $ 6.50 <br />3Ton and up $11.00 <br /> <br />AIR CONDITIONER <br />under 3 Ton $ 6.50 <br />3 Ton and up $1 L00 <br /> <br />EvaporativeCooler $ 4.50 <br />CoJllmeJ'~Ja] Exhaust System $ 4.50 <br />Commercial Hood and Exhaust $ 4.50 <br />Domestic Range Hood $ 4.50 <br />Domestic ~xhaust Fa~s <br />~d Dryer V~nts $ 3.00 <br /> .o t ~-~-~ v $7.50 <br /> <br />Commercial / Industrial Incinerator $30.00 <br /> <br />ADDITIONAL APPLIANCES <br />Gas Water Hezter $ 7.50 <br />Gas Log Lighter $ 7.50 <br />G~ Barbeque $ 7.50 -- <br />Other $ 7,50 <br /> <br />GAS PIPING SySTBM <br />14 outlets (per out/et) $ 2,00 ~,~ ~/~ <br />4 and up outletg (per out/et) $ 30 <br /> <br />OTHER tvs required by guil&~ Ol~ciM) <br /> <br />3. PLANRBVIBW SECTION <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 wi, this application. <br /> <br />MC 1541 <br />REV 8/96 <br /> <br />5. FEES Al. Enter total of feea fiom Sec. ~4 <br /> A2. Add 5% surcharge (.05 x Al) <br /> <br /> B, ~r 25% of J~e A 1 f~ PI~ Renew <br /> L <br /> (A 1 + .25), if r~uired <br /> C. l~esi~ation Fee (if~qui~d) <br /> D. Re~pcction Fec ($25.~) - <br /> <br /> <br />