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FOR CITY USE ONLY <br /> Received By:. .Date: <br /> Zoning By: City: <br /> Receipt #: Amount: $. <br /> <br /> MECHANICAL PERMIT APPLICATION <br /> Please complete all Sections, I through 5 I <br /> <br />1. LOCATION OF INSTALLATION <br /> <br />PERMITS ARE NON. TRANSFERABLE AND EXPIRE IF WORK <br />IS NOT STARTED WITHIN 180 DAYS OF ISSUANCE OR IF <br />WORK IS SUSPENDED FOR 180 DAYS. <br /> <br />2A. CONTRAL"TOR INFORMATION-- PLEASE INDICATE <br />WHO IS DOING THE WORK <br /> <br /> Con~Pactou. <br /> <br />Mailing Addmss: <br /> <br />City: State: <br />Phone: <br /> <br />Zip: <br /> <br /> Contractor's 5igaature: <br /> <br />2B. FOR OWNER INSTALLATION <br /> <br />1 ~ t~ PROPER~ O~ER a~ ow~ ~side in. or will reside in <br />the ~mpleted *~c~ ~ will be my own general contracton 1 <br /> <br />s~mm is soM or offered for sa~ befo~ or upon co~lttiom If l <br />the Cons~ction Contracto~ ~a~. lfl c~nge my mind a~ do <br />Commctors B~ l wilt t~diate¢ ~t~ Ma~n Co~ of the <br /> <br />~ent's Silage: <br /> <br />3. PLAN REVIEW SECTION <br /> <br /> Marion County does not require a plan review. We will provide plan <br /> review service if you complete Section 5B and submit two (2) sets of <br /> pans and specifications with this application. <br /> <br />MC 15-41 Rev 9/98 <br /> <br />MARION COUNTY BUILDING INSPECTION <br />COMMUNITY DEVELOPMENT CENTER <br />3150 Lancaster Dr. NE - Suite C, Salem, Oregon 97305 <br />8:00ara - 4:30pm <br />24 HR Inspection Line 373-4427 FAX 588-7948 <br /> <br />4. FEE SCHEDULE (complete and enter total in Al) <br /> <br />) RESIDENTIAL ( ) COMMERCIAL <br />) NEW ~ ADDITION <br />) l~l. OC~'rloN ( ) REPLACE'~.,brr <br /> <br /> OTY <br />~ (include~ ducts / vents) s/ ~N~ <br /> <br />Piping <br />3 Ton aad Mo~ ./~ x $~.00 = $__ <br /> <br />5. FEES <br />BASE FEE Assessed on ALL APPLICATIONS: <br /> Al. Enter total of f~es fi'om Sec. ~4 <br /> A2. Add Stale Surdaarge (.05% x A1 + Base F~) <br /> <br />SUBTOTAL <br /> <br />.~.00 <br /> $__ <br /> $__ <br /> <br /> $__ <br /> $__ <br /> $__ <br /> $__ <br /> <br />TOTAL AMOUNT DUE <br /> <br />B. Enter 30% of linc Al for Plan Review <br />C, Investigation Fe~ (if requked) <br />D. Reinsl~ction Fe~ ($50.110) <br />E. Additional Plan Review ($62,50&r, <br /> ndnimum one-half hour) <br />E Inspection for which no foe is specifically indicated, <br /> ($62.50/hr, midimum oa~ hour) <br />G. Inspection Outside Normal Busines~ Hoars, <br /> ($6230/hr, minimum two hours) <br />1t. Seismic Fee {.01% x Al)) <br /> <br /> <br />