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FOR CITY USE ONLY Received By: Date: Zoning By: City: Reoeipt #: Amoum:$ MECHANICAL PERMIT APPLICATION Please complete alt Seclions, I through 1. LOCATION OF INSTALLATION Parcel ID: Cross Strcet/Directions: 2A. CONTRACTOR INFORMATION -- PLEASE INDICATE WHO IS DOING THE WORK Fax: Property Ovalcr: (please prinO Mailing Addr~s: City: State: Zip: Phone: Fax: I am the PROPERTYOWNER and own, reside in, or will reside in the completed structure and wBI be my own general contractor. 1 understand that I must register as a construe#on contractor if the structure is sold or offered for sale before or upon completion. If[ hire subcontractors, I will hire only subcontractors registered with the Construction Contractors Board. Itl change my mind and do hire a general contractor who is registered with the Construction Contractors Board, I will immediately noti~. Marion County of the name of the contractor: Owner's Signature: Agent's Signature: 3. PLAN REVIEW SECTION Marion County does not require a plan review. We will provide pins re,tiew sowiee if you compIOe Section 5B and submit two (2) sets of plans and specifications with this application. 4. FEE SCHEDULE (complete dud eater total in Al) MARION COUNTY B I~ING INSPECTION COMMUNITY DE~J1L]O~MEI~ CENTER 3150 Laacaste[ ,D?. ~NE.~e~[~h~Salcrn, Oregon 97305 24 hr. Ins 7 FAX 588-7948 n~"~ -~" ~ l~/ ~IDENTIAL ( ) COMMERCIAL BBI (.~mW ~).~tDDIWI ON ] ., rail [~n~LOCATION ( ) REPLACEMENT ~l.~' '-- Forced Air up to 100,000 BTU Fo{e~d Air over 100,000 BTU Floo~ Furnace Ducts ( Altemt ions/Extension ~ GAS [ ) ELECTRIC ALTERATION ~00 O~, QTY x $12.00 x $15.00 x $12.00 x $15.00 x $12.00 = $ x $15.00 = $ x $15.00 = $ x $15.00 = $ x $15.00 = $ x $15.00 = $ Gas Piping Each outlet up to 4 outlets Each additional outlet ove~ 4 outl~s x $ 4.00 = $ x $ 1.00 = $ Heaters S u.~oended Heate~ Wall H~ater FIcor Mounted x $12.00 x $12.00 x $12.00 Heat Pumo Under 3 Ton 3 Ton and More x $12.00- $ x $22.00 = $ Air (~9adifioner Under 3 Ton t Ton and More Evagorative Cooler $15.00 = $ $22.00 = $ x $9.00= $ Exhaust I Fans / Vents Coral Exhaust S!,~em Coral Hood & Exhaust Domestic Range Hood (includes ducts'~ Domestic Exhaust Fans Domestic Dryer Vents Appliance Yeats installed and net included in an appliance permit $ 9.00 = $ $9.00=$ $ 9.00 = $ $ 6.00 = $ $ 6.00 = $ x $6.00= $ Additional Aaaliances/g.D Fire Damper x $15.oo x $ 6.00 = x $60.00 One/T~ Family Dwelling Fee Square Feet: __ x $ .04 = $ Dwelling Permit Labels # of Labels __ ~ $ N/C (For New Drillings Only) Other (as required by the Building Official) $ FEES BASE FEE Assessed on ALL APPLIOI ?'IONS: $ 25.00 Al. EmerTotal Fees from Section #4 $_~,~-~$ ~, - _ A2 Add State Surcharge (.05% x Al) $ '.~I~ .a SUBTOTAL: B. Enter .30% of line Al for Plan Review $ ~ C. lnvestigetioa Fee, if required $ _ ~ D. ReinspeetionFee($50.00) $ ~- E. Additimml Plan Review, $62.50thour, ( minimum one half hour) $ F. Inspection for which no fee is Sl~Cifically indicated, $62.50Par, (minimum one hou0 $ G. Inspection Outside Norraal Business Hours, $62.50/hr, (minimum two hours) H. Seismic Fee (.01%x Al) $ MC 1541 Rev 9/98