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Mechanical Permit Application <br /> <br />Appl, Racd: <br /> <br />By:. <br /> <br />Date: <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. <br /> <br /> Mechanical Permit Application <br /> <br /> Bldg. Permit No. ~-~/ ~ <br />Mechanical Permit No, //~ <br /> Date: <br /> <br />Type of Permit: WOOD <br /> <br />Tax Lot No: <br /> <br />Address: <br /> <br />Sec. Twnshp. Rge. <br /> <br />Owner: ~%A'O'r[~TS A 7fT~ON' <br /> <br />Phone: ?~9-;?~R Address: ,~F~ <br /> <br />Bldr. & No.: Sk~r~, ., <br /> <br />Phone:. Address: <br /> <br />Plans by: Phone: <br /> <br /> [] New Installation <br />Application is made for; [] Addition <br /> <br /> Appliance · <br /> Make ...... <br /> BTU Input Floor Area <br /> <br /> Vent Size Fuel "' <br /> <br /> Comments: <br /> <br />Approved By: <br />Date: <br /> <br /> Address: <br /> <br />[] Replacement <br />[] Gas Connection <br /> <br />' ITEM NO. FEE kMOUN~' <br />"For issuance of Permit 10.00 <br /> New Install. LS 1000,000 BTU ., 6,00 <br />Replacement LS 100,000 BTU 6.00 <br />New Install. More 100,000 BTU 7.50 <br />Replacement,..M,(~re 100,000 BTU 6.00 <br />New Install. Floor Furnace 6.00 <br />_. Replacement.. Floor Furnace 6·00 <br />New Install'· Suspended Heater ' 6,00 <br />Replacement Suspended Haste. r, 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 .M. ounted Unit ~eater 6.00 <br />Boiler/Compr. 3 hp, 100,000 BTU 6.00 <br />Boiler/Compr. 15 hp, 500,000 BTU 11 <br />Boiler/Compr, 30 bp.,1.1,000,000 BTU 15.00 <br />Botler/Compr, 50 hp, 1 ~750~000. BTU 22.50 <br />Boiler/Compr. over 50 hp, 1,750,000 BTU 37.50 <br />Air Handling'Unit to'10,000 cu. ft. 4.50 <br />Air Handling._U..nit over 10,000 cu, ft. 7.50 <br />· Evaporative Cooler 4.50 <br /> Exhaust System Commerci.al. 4.50 <br /> Hood a~d Exhaust Commercial 4,50 <br /> Domestic Type Incinerator & Wood Stoves 7·50 <br /> (~ommerclal or Industrial Incinerator 30.00 <br /> Gas Connect.ion,Without Appliance (1 to 4 each) 2,00 <br /> Over 4- $8,00 Plus Each Additional .50 <br /> Apprlanse or A~essory to Any Heatln or <br /> · Comfort Coolin~ S~/stem N~t Covered %gbove 4.50 <br /> <br /> ~ ,~----_.~ (~07~ FEE $ 17o50 <br /> SURCHARGE $ o?0 . <br /> <br />I , 19 TOTAL ~ <br /> <br />I agree to instal/according to the submitted plans and specifications, the laws of the State of Oregon and the Ordinances of <br />Marion County. Permit expires if work not commenced within 120 days. I further expressly warrant that I comply with the prevl- <br />s/onE 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 will be performed by a registered contractor; <br />'(~'~1 am ~erforming work on a property I own or occupy <br />( ) Other(please pecify) \/ ,/ <br />SIGNATURE OF APPLICANT: X l //~* ~~//~ <br /> <br /> <br />