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MARION coUNTY <br />-~ ~IUILDING INSPECTION DIVISION <br /> so LA.CASTE" <br />FOR. CITY VALIDATION SALEM OREGO~ 97305-1398 <br />R~e~ved by:~ / Date: <br /> <br />~ o~~~. - 4:30 p.m. ISSU~ by: <br /> / <br /> <br /> Pleese complete ~1 Sections, t through 5 <br /> <br />D~cripfiowDd{rccdo.s <br /> <br />I <br /> <br />ZA, CONTRACTOR INSTALLATION ONLY <br /> <br />2B, POE OWNER IN,'~{TALLATION;t <br /> <br />Msili.! Address <br /> <br />3. PLAN RBVII]W SECTION <br /> <br />Markm County does not tequhe a pla. review. <br />We will provide plan review ,e~ice ffyou complete <br />S~tion 5B and submit two (2) set~ of plans and <br />speclflcati~s wlfl~ fids application. <br /> <br />IIEAT PUMP <br /> 'J.der 3 To. <br /> ~{ T.n snd .p <br /> <br />AIR CO{~D[]'IONITR under 3 Ton <br /> <br /> ~d ~ Vemm <br /> <br />$ 6.00 <br />$ 6.00 -- <br />$ (LO0 <br /> <br />ADDITIONAL APPLIAHC{E9 Oas Water Ileater <br /> Ohs {~ng L{ghler <br /> <br />S 6.50 <br />$11.00 <br /> <br />$ 6,50 <br /> <br />$ 4.50 <br />$4.~0 <br /> <br />S 4.~ <br /> <br />$ <br /> <br />$7.50 <br />S 7.~ <br />S~o.o0 <br /> <br />$7.50 <br /> <br />$7.~ <br />$ 7.~,0 <br /> <br />2.00 <br /> .~0 <br /> <br />S <br /> <br />5. FBI]5 <br /> <br /> A2. Add 5% surcharge (.0~ x Al) { <br /> <br /> (Al + .25), ii re~ed S~ <br /> C. InvesfiSnt~n Fee (if ~quir~) $. <br /> D. Rd~pectie. Fee (~5.~) ~,~ <br /> <br /> <br />