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.................................... ; MARION COUNTY BUILDING INSPECTION <br />FOR CIYY USE ONLY COMMUNITY DEVELOPMENT CENTER <br /> Received By: .Date: 31150 Lancaster Dr. NE- Suite C, Salem, Oregon 97305 ' ~/~ 5 <br /> Zoning By: City: | 8:00am- 4:30pm , ,a/ -I <br /> <br /> ..................................... ~t~l~/ 4. FEE SCHEDULE (cempinte and enter tet~l in Al) <br /> MECHANICAL PERMIT APPLICATION I , ,,.3c ~ (X) RESIDENTIAL ( ) COMMERCIAL ( ) OAS ~ ELECTRIC <br /> Please complete all Sections, I through 5 ~f. t~ [) NEW ~ ADDITION ( ) ALTERATION <br /> ~'~ .,i~,tt~ ()RELOCATION ( ) REI~AC~MENT <br /> OTY <br /> 1. LOCATION OF INSTALLATION _ ~ ,t ~ ~ ~ ] leurna~ (includes ducls/ vmts) <br /> <br />PE~ITS ~ NON-~NSFE~ AND EXPI~ IF WO~ ~ <br />IS NOT ~TA~TED ~THIN 180 DAYS OF ISSUANCE OR IF <br />WORK lS SUSPENDED FOR 180 DAYS. <br /> <br />fA. CONTRAC'rOR INFORMATION -- PLEASE INDICATE <br />WHO IS DOING THE WORK <br /> <br /> i ~)~' <br />2B. FOR OWNER INSTALLATION <br /> <br /> Property Owner: (please print) <br /> <br />Mailing Add~ess: <br /> <br />City: State: <br /> <br />Zip: <br /> <br />am the PROPERTY OWNER and own, reside in, or will reside in <br />the completed structure and will be my own general contractor. I <br />understand that I must register as a construction contractor if the <br />structure is sold or offered for sale before or upon completion, ltl <br />%ire subcontractors, I will hire only subcontractors registered with <br />'he Construction Contractors Board. ~f l change my mind and do <br />~ire a general contractor who is registered with the Construction <br />Contractors Board, I will immediately notify Marion County of the <br />name of the contractor. <br /> <br />Owner's Sigflature: <br />Agent's Signature: <br /> <br />3. PLAN REVIEW SECTION <br /> Marion County does not require a plan review. We w~ll provid~ plan <br /> review service if you complete Section 5B and submit two (2) sets of <br /> p aris and spec flea,ohs with this app ication. <br /> <br />MC 15~1 Rev 9/98 <br /> <br />Forced A~ up to l00,000 BTU -- x $12.00=$__ <br />Forced Air ov~t 100,000 BTU -- x $15.00 = $ <br />FleorFurnacc -- x $12.00=$ <br />Ducts (Alterations~x~nsion) -- x $15.00 = $ <br /> <br />Oas Fumace (up to l00,000 BTU) -- x $12.00=$ <br />~asFumac~(ovexl00,000BTU) -- x $15.00=$__ <br />~osFireplaee/Inscrt -- x $15.00=$__ <br /> <br />Om Log Lighte~ -- x $15.00=$__ <br />GasBad~lUe -- x $15.00=$ <br />~as Piping <br /> <br />Suspended Heater -- x $12.00=$ <br />WallHeat~r -- x $12.00=$.__ <br /> <br /> 5 Ton and More { x $22,00 -- $ <br /> <br />Evaporative Coolex -- x $9,00 = $ <br /> <br /> Coral IL'ahaust $yst:m -- x $9.00 = $ <br /> Coral Hood & Exhaust -- x $9.00 = $ <br /> Domestic Range Hood (includes duets) -- x $9.00 = $ <br /> <br /> Domestic Dryer V~nts -- x $6.00 = $ <br /> <br /> Fir~ Damper -- x $6.60 = $ <br /> Comi I lndus~al Incinerato~ -- x $60.00 = $ <br /> <br /> Oaetl'~l~m~a~etl~Fee:aqu~eFeee -- x $ .04=$__ <br /> <br />SUBTOTAL <br /> <br />B. Enter 30% of line At for Pian Review <br />C. Investigation Fee (if required) <br />D. Reinspection Fee ($50.00) <br />E. Additional Plan Review ($62.50/hr, <br /> minimum one-half <br />E Inspection for which no fee is specifically indicated,/~? <br /> ($62.50/hr, minimum one hour) <br />O. Inspection Outside Normal Business Hours, <br /> l$62,50/hr, minimum two hours) <br />H. Seismic Fee (.01% x Al)) <br /> <br />TOTAL AMOUNT DUE <br /> <br />$__ <br />$__ <br />$__ <br />$__ <br /> <br />$__ <br />$__ <br />$__ <br /> <br /> <br />