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Mechanical Permit Application
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<br />Appl. Recd:
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<br />By:
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<br /> MARION COUNTY
<br /> DEPT. OF BUILDING INSPECTION
<br /> Senator Building # 225
<br /> 220 High St,, N.E. 2nd Floor
<br /> Salem. Oregon 97301
<br />R.H. WITHROW, SLOG_ ADMINISTRATOR
<br />588-5147 ~ 588-5148.
<br />5:00 P.M,- ........... CODE-A.Phoee 588,5373 ............. 8:00 A.M,
<br />
<br />Mechanical Permit Application
<br />
<br />Bldg. Permit No ....
<br />Mechanical Permit No. 82-604
<br />Bate: 7/7/82
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<br />/
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<br /> 1
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<br />Tax Lot No:
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<br />Phone:__
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<br />BIdr. & No,: ]~'~-,~ --! s ....~-v "-' '~ ~:~S
<br /> Phone:_~ ' ~,_
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<br /> ~ New Installation
<br />Application is made for: ~" Addition
<br />
<br />Appliance
<br />Make
<br />BTU Input Floor Area
<br />Vent Size Fuel ......
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<br />Comments:
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<br />Approved By'. ,L ~-'
<br />Date:
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<br />Twnshp ..... Rge __
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<br /> Address:_
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<br />Replacement
<br />Gas Connection
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<br /> iTEM NO. FEE AMOUNT
<br /> For I~'suance of"Permit 10.00
<br /> NewtnstaH Ls1000,000 BTU 6.00
<br />Replacement Ls 100,000 BTU 6.00
<br />New Install, More 100~000 BTU 7,50
<br />~Reptacement More 100,000 B']U 6.00 ......
<br />New Install. Floor Furnace 6.00
<br /> Replacement Floor Furnace ................. 6.~00~
<br /> New ~nstall. Suspended Heater 6.00
<br /> Replacement Suspended Heater__ ..... 6.00 ....
<br /> .... New Install. Wall Heater ...... 6,00 _.
<br /> Re,placement Wall.Heater 6,00
<br /> New Floor Mounted Unit Healer 6,00
<br /> Re,l:)l~ce Floor Mounted Unit Heater ,, 6,00
<br /> Boiler/C. ompr, 3 hp, 100,000 BTU 6,00 ....
<br /> Boiler/tempt,; 15 bp, 500,000,BTU ...... 11.00
<br /> Boiler./Compr, 30 hp, !,,~000,000 BTU ,,, 15-00 _~
<br /> Boiler/Compr. so bP, 1,750,000 BTU ~2.50 __,
<br /> Boiler/Compri o?r 50 bp, 1,750,00'0'"B:?_.~U ....37.50
<br /> Air Handl,!ng Unit to 10,000 e,.u., ft, 4,50 .~
<br /> Air Handling Unit ov¢,r,,1.,0,O00 cu. ft. 7,50
<br /> EvaEprative Cooler ' 4',50
<br /> Exhaust Syst~,m Oomm'~'~cJal ....... ~ 4',50
<br /> Hood and,,,Exhaust Commer,¢al _ 4,50 ,
<br /> Domestic Typ~ Incinerator & Wood Stov.e,,.s_ ~,,;.50
<br /> ,Commercial or Inc!,ustrial Incinerator ...... 30,00
<br /> Gas Connection Without Appliance (1 to 4 eaci~) 2.00
<br /> Over 4 - $8,00 Plus Each Additional /4. .5~ 8 · O0
<br /> ,,Comfort Coolin~ S~stern Not Covered Above 4.50
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<br /> SURCHARGE
<br />, 19__ TOTAL
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<br />I agree to install according to the submitted plans and specifications, the laws of the State of Oregon and the Ordinances of
<br />Marion County, Permit expires it work not comreenced w/thio 120 days I lurther e~pressly warrant lhat / comply with the pravJ.
<br />aiona of ORS 701.005 to 701,125 because:
<br />(.~ I am a registered contractor or ( ) the authorized representative of a registered contractor.
<br />{ ) The work wilt be performed by a registered contractor.
<br />( ) I am performing work o~-p¢ol~rty I own~or ~cupy
<br />( ) Other(pleaseAPPLiCANT,,.specify)/~'
<br />SIGNATURE OF
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