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Mechanical Permit Application
<br />lay:
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<br />Type of Permit:..·
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<br />Address:. 91~ N. 7th
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<br />Owner' ~/--,~g~J .~7~,..,,~, Phone: 7~/<~- /'~ Address:
<br />Bldr. & NO.: ~ Phone: . . Address:
<br />Plans by: / Phone: Address:
<br />
<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. WlTHROW, BLDG. ADMINISTRATOR
<br /> 588-5147 -- 588-5148
<br /> 5:00 P,M.- .......... CODE-A-Phone 588-5373 ............. 8:00 A,M. Date;
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<br />,~20-¢~ I~k' ~_~±D~E Tax Lot No:
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<br /> A~ ;MSVILLE
<br /> .... Sec. Twnshp.
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<br />Mechanical Permit Application
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<br /> ~ldg. Permit No,.
<br />Mechanical Permit No.
<br />
<br />Rge.
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<br />Application is made for:
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<br /> Appliance,
<br /> Make
<br /> BTU Input, Floor Area
<br /> Vent Size ' Fuel,
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<br />Comments: ,
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<br />[~New I.nstall~,tion ,. 'r-] .Replacement
<br />r~' Addition [] Gas Connection
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<br />ITEM NO. FEE ~,MOUNT
<br />,For Issuance of Permit 10.00
<br />"'1~ ew I ostall. Ls 1000,000..B,~U. 6,00
<br />, R~laceme~t Ls .100,000 BTU 6,00
<br />New Install, More 100 000 BTU 7.50
<br />' Replacement More 100,.0.0.0 BTU 6,00
<br />New Install. Floor Furnace 6.00
<br /> ~acemsnt Floor Furnace 6.00
<br /> New. Install, Suspended Heater 6.00
<br /> .R., .e, placement Suspended Heater 6,00
<br /> New Install. Wall Heater 6.00
<br /> Replacement Wall Heater 6.00
<br /> , New Floor Mounted Unit Heater 6.00
<br /> Replace Floor Mounted Unit Heater 6.00
<br /> Boiler/Compr. 3 hp 100,000 BTU ,, 6.00
<br /> Boiler/Compr. 15 hp,.,5.00 000 BTU 11.00
<br /> Boiler/Compr. 30 hp, 1;000~O00~BTU ' ~ '
<br /> , 15.00
<br /> Boi ler/Com.p_r.·.'50' h-P ,': 1,750;000 BTU 22.50
<br /> Boile~;/Com_P=[t. over 50 hp, 1,750,000 BTU 37.50
<br /> Air Handling Unit to 10 000 cu. ft. 4.50
<br /> 'Air Ha.[~dling Unit.over 10,000 cu. f!. 7.50
<br /> . Evaporative Cooler 4.50
<br /> Exhaust System Commq.r~ial 4,50
<br /> · Hood.and Exhaust Commercial 4,50
<br /> Domestic Type Incinerator & Wood Stoves 7:~50 '?, '~o
<br /> · Commercial or Industrial.Incinerator 30.00
<br /> Gas,Connection Without App ance (1 to 4 each) 2.00
<br /> Ove~ 4 - $8.00 Plus Each Additional
<br /> cornfor~ Coolin~ Sy,s,,t em Not Covered Above 4.50
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<br /> FEE
<br />Approved By: .~,,- ,~ SURCHARGE¢/¢
<br />Date: Cr.~ , 1¢~ TOTAL
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<br />I agree to instal/according to the submitted Plans and sl~ecificationa, the laws of the State of.Oregon and the Ordinances of
<br />Marion County, Permit ex~ires if work not commenced within 120 days. I further expressly warrant that I comply with the Provl,
<br />sions of ORS 701,005 to 701,125 because:
<br />( ) ! am a registered contractor or ( ) the,authorized representative of's registered contractor,
<br />( ) The work will be performed by a registered contractor.
<br />( ) I am performing work on a prpp~ I own or occupy
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<br />SIGNATURE OF APPLICANT: ~ ~.-~_A.-q/~L. /J _ .
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