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FOR CITY VALIDATION{ <br />Received By: <br /> <br />Date: <br /> <br /> MARION COUNTY <br />BUILDING INSPECTION DIVISION <br /> 3150 Lancaster Dr. NE - Suite C <br /> Salerr~ Oregon 97305-1398 <br /> <br /> 24 HR I~pe~on Line 375-4427 <br />Office: phone 588-5147 $:00am - 4:~0pm <br />FAX 588-7945 <br /> <br />MECHANICAL PERMIT APPLICATION <br />Please complete all Sections, I through 5 <br /> <br /> 1. LOCATION OF INSTALLATION <br /> <br />. D~ONS <br /> <br />PERMITS ARE NON-TRANSFERABLE AND EXPIRE IF WORK IS NOr <br />STARTED WITHIN 180 DAYS OF ISSUANCE OR IF <br /> WORK IS SUSPENDED FOR 180 DAYS. <br /> <br />2A. CONTRACTOR INSTALLATION ONLY <br /> <br />Mechanical Contractor <br />Mailing Address City <br /> <br />PHONE ,.-- ~ <br />FAX ~- ~ <br />CONTRACTORS BOARD <br />REGISTRATION NO. <br /> <br />CONTRACTOR'S SIGNATURE <br /> <br />2B. FOR OWNER INSTALLATIONS <br /> <br /> Marling Address lOqt~l ~J~.~ <br /> City, S~m, Zip ~M fO[~ <br /> <br /> Ag~m's Sign~ <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 />Date: <br /> <br />Issued by: <br /> <br />4. FEE SCHEDULE (Complete and enter total in Al below) <br />RESIDENTIAL [~ COMMERCIAL O USE: <br />NEW D ALTI~,A'noN ~ ^DDrno~ ~ I~LOCA~nON O P,~,',.3.CE ~ <br /> ~AS ri ~muc D <br />BASE FEE ASSESSED ON ALL APPLICATIONS $10.~0 <br /> <br />GAS FURNACE (up to 100,000 BTU) <br />GAS FURNACE (over 100,000 BTU) <br />OAS FIREPLACE/INSERT <br /> <br />GAS BARBEQUE <br /> <br />OTY <br /> <br />x $6.00 =$ <br />x $7.00 = $ __ <br /> <br />x r~.O0 =$ <br />x $7.50 = $ <br /> <br />x $6.0o <br />x $7.00 <br />x $7.$0 <br />x $730 <br />x $7.50 <br />x S?.~0 <br /> <br />x $2.00 <br /> x $.50 <br /> <br />x $6.00 <br />x $6.00 <br />x $6.~ <br /> <br />=$ <br /> <br />x $6.50 <br /> <br />x $3.OO <br /> <br /> x $7.50 <br /> <br />x $3o,oo <br /> <br />5. FEES <br /> Al. Enter t~tal of f~s from Sec. #4 <br /> A2. Add 5% sumhalg¢ (.05 x Al) <br /> <br />B. Enter 25% of line Al for Hah Review <br /> (Al + .25), if required <br />C. Investigation Fee (if requi/ed) <br />D. Rei~sp~etion Fee ($25.00) <br /> <br />£ec~ipt No. <br /> <br />Subtotal <br /> <br />TOTAL AMOUNT DUE <br /> <br />MC 15-41 7/97 <br /> <br /> <br />