Laserfiche WebLink
-~ CITY VALIDATION] <br />IReceived By: <br />Date: <br /> <br /> MARION COUNTY <br />BUILDING INSPECTION DMSION <br />3150 Lancaster Dr. NE - Suite C <br /> Salem, Oregon 97305-1398 <br /> <br /> 24 HR Inspection Line 373-4427 <br />Office: phone 588-5147 8:00am - 4:30pm <br />FAX 588.7948 <br /> <br />MECHANICAL PERMIT APPLICATION <br />Please complete all Sections, I through 5 <br /> <br />1. LOCATION OF INSTALLATION <br />TAX ACCOUNTNO. I I <br /> N ,tle <br /> <br />%wow~R;S 5 o - ~- 5 6 3 <br />c~o~ ~ ~ r~d P <br />D~ONS <br /> <br /> PERMITS ARE NON-TRANSFERABLE AND EXPIRE IF WORK 1S NOT <br /> STARTED WITHIN 180 DAYS OF ISSUANCE OR IF <br /> WORK IS SUSPENDED FOR 180 DAYS. <br /> <br />2A. CON~I~A~T~F~LLATION ONLY ~]L~t~,t~ <br /> <br />Mechanical Contractor <br />Mailing Address City <br /> <br />CONTRACTORS BOARD <br />REGISTRATION NO. <br /> <br /> CONTRACTOR'S SIGNATURE <br /> <br />2B. FOR OWNER INSTALLATIONS <br /> <br /> Property Owner (please print) i~ <br /> <br />City, State, Zip <br /> <br /> Owner's Signature <br /> <br /> Agent's Signature <br /> <br />3. PLAN REVIEW 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 with this application. <br /> <br />PERMIT NO: <br /> <br />Date: <br /> <br />Issued by: <br /> <br />4. FEE SCHEDULE (Complete and enter total in A1 below) <br />RESIDENTIAL ~ COMMERCIAL [~ USE: <br />hr~V [] ~TE?.nTtON El ADDmON fl V.£COC^~ON ~ ~FL^C~ gl <br /> GAS ~ ELECTRIC I'l <br />BASE FEE ASSESSED ON ALL APPLICATIONS $10.00 <br /> <br />FURNACE OTY <br />FORCED ALR UP TO 100,000 BTU x S6.00 <br />FORCED AIR OVER 100,000 BTU x $7.00 <br />FLOOR FURNACE ~ x $6.00 <br />DUCTS (ALTFJK~TION/EXTENSION) x $7.50 <br /> <br /> / <br />GAS FORNACE (up to 100,000 BTO) x $6.00 <br /> <br />GAS FURNACE (over 100,000 BTU) x $7.00 <br />GAS FIREPLACE/INSERT x $7.50 <br />GAS WATER HEATER x $7.50 <br />GAS LOG LIGHTER x $7.50 <br />GAS BARBEQUE x $7.50 <br /> <br />GAS PIPING <br />Each outlet up to 4 outlets / x $2,~0 <br />Each additional outer over 4 outlets x $.50 <br /> <br /> SUSPENDED HEATER x $6.00 <br /> WALL HEATER x $6.C0 <br /> FLOOR MOUNTED x $6.120 <br /> <br /> HEAT PUMP <br /> UNDER 3 TON x $6.50 <br /> 3 TON AND MORE x $11.00 <br /> <br /> AIR CONDITIONER <br /> UNDER 3 TON x 56.50 <br /> 3 TON AND MORE x $11.00 <br /> EVAFORATIVE COOLER x $4.50 <br /> EXHAUST [ FANS / VENTS <br /> <br />5. FEES <br />Al, Enter total of fees from Sec. #4 $ <br />A2. Add 5% surcharge (.05 x Al) $ <br /> Subtotal $ <br /> <br />B. Enter 25% of line A1 for Plan Review <br /> (Al + .25), if requited <br />C. Investigation Fee (if required) <br />D. Reinspection Fee ($25.00) <br /> <br />Receipt No. <br /> <br />TOTAL AMOUNT DUE <br /> <br />MC 15-41 7/97 <br /> <br /> <br />