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( ) Readyforlnspectlon ~,.. ~,ril~l~ COUNTY ( } WIIIcallforinapection <br /> <br />Date: ~ ~ . ~ ~ Salem, Oregon 97301 BLDG. PERMIT NO: <br /> <br />~y: /~ d /~3b~ "'~AcHANicAL PERMIT Bec.. ~.M,~gO: <br /> <br />Type of Perm t: <br /> <br />Address: <br /> <br />6~5 Clevel~nd~ Au~svllle <br /> <br />Owner: <br /> <br />Installer: <br /> <br />BET?~L BAPTIST CHURCH Phone: 749-2198 <br /> GAGLES HEATIEG & AIR COND_.Phone: ~81~£972 <br /> <br />Address: 645 Clevel~nd~ Aumsvflle <br /> <br />Address: 2989 Pringle Rd. $.E. <br /> <br />Application is made for: <br /> <br />Appliance E.~GM!2 SDK <br />Make Heil <br /> <br />BTU input <br />Vent Size <br /> <br />( : ) New Installation (ddcl~-Replacement <br />( ) Addition ( ) Gas Connection <br /> <br /> NO. FEE AMOUNT <br /> Base Price 1 10.00 <br /> ~ 18~ oo <br /> Forced air furnace 100,000 BTU or less 6,00 <br /> Forced air furnace over 100,000 BTU 7,50 <br /> Froot Furnace 6.00 <br /> Suspended Heater 6.00 <br /> Wall Heater 6.00 <br /> Floor Mounted Unit Heater 6,00 <br /> Heat Pump 6.00 <br /> Air Handling Unit to 10,000 cu. ft, , ................. 4,50 <br /> Air Handling Unit over 10,000 cu, ft. 7.50 <br /> Evaporative Cooler 4.50 <br /> Exhaust Syatem Commercial 4.50 <br /> Hood and Exhaust Commercial 4.50 <br /> Domestic Range Hoods 4.50 <br /> Dome~t.!,.c. Exhaust Fans & Dryer Vents 3,00 <br /> Domestic Wood Stove 7.50 <br /> Commercial or Industrial Incinerator 30.00 <br /> Fire Damper 3.00 <br /> Gas Water Heater 7,50 <br /> Gas Connection W/o Appliance (1-4 each) 2,00 <br /> over 4- $81'00 plus aa, addnl, 50 <br /> Appliance or accessory to any heating or <br /> Comfort cooling system not covered 4.50 <br /> Other (as per Mechanical Code); <br /> FEE <br /> <br />Please return COMPLETE APPLICATION 4% <br />with the indicated fee. PLAN REVIEW FEE $ 1 <br /> iNVESTIGATION FEE$ <br /> FLEET SURCHARGE <br /> TOTAL <br /> <br />Floor area <br /> Fuel <br /> <br />COMMENTS: <br /> <br />I agree to install according to the submitted plans and specifications, the laws of the State of Oregon and the <br />Ordinances of Marion County. PERMIT EXPIRES IF WORK NOT COMMENCED WITHIN 180 DAYS, I further warrant <br />that I comply with the provisions of ORS 701.005 to 701.125 because: <br /> <br />) <br />) <br />) <br /> <br />SIGNATURE OF APPLICAN <br /> <br />I am a registered contractor or ( ) the~utho~.ed representative of a registered contractor. <br />The work will be performed by a registered contractor, <br />I am performing work on a property I own or occupy, <br />Other (please s~~,,.~ ~ BLDRS BOARD REGISTRATION # <br /> <br /> <br />