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Mechanical Permit Application
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<br />Appl. Recd: ~"'--,~,
<br />
<br /> MARION COUNTY Mechanical Permit Application
<br /> DEPT. OF BUILDING INSPECTION
<br /> senator Building # 225
<br /> 220 High St., N.E. 2nd Floor Bldg. Permit No. ' ....
<br /> Salem, Oregon 97301
<br /> R.R. WITHROW, BLDG. ADMINISTRATOR Mechanical Permit NO,,,~,¢~''~ ~/¢;2,";~'%~
<br /> 588-5147 -- 588-5148
<br />P,,M.- ............ OODE.A.Phone 588-5373 ............. 8::00 A.M,, Date:
<br />
<br />Type of Permit: WOOD STOVE
<br />Addre~.'~ 11937 Cause,y Lane $. E.
<br />Owner.~ Wm. Holden
<br />
<br /> FUEG0 NORTHWEST INC
<br />Bldr, & NO.: 3836'/
<br />Plans by:
<br />
<br />Pho
<br />Phone: 7,~. 1166
<br />
<br />Phone:
<br />
<br />Tax Lot No;
<br />
<br /> Sec,, Twnshp, ,Rge,
<br />
<br />Address'~, 119~7 Ca~zsey L~,~e S, E,,,
<br />Address: P 0 BOX 66312 PORTLAND OR
<br /> 97266
<br />Address:
<br />
<br />Application is ~ade for: [] Addition
<br /> Applia0~e/~j~ Wood St;o'ce
<br /> Make,~_ TrailBlazer Hugger
<br /> BTU Input Floor Area
<br /> Vent Size_ Fuel
<br />
<br /> Comments:
<br />
<br />[] New h3stallation [] Replacement
<br /> [] Gas Connection
<br />
<br />ITEM .... NO. FEE, AMOUN1
<br />For issuance of Permit 10.00
<br />New Install. LS ! 000,000 BTU 6,00
<br />R.e. placement Ls 100 000 BTU 6,00
<br />New Install. More 100.,000 BTU 7,50
<br />Replacement More 100,000 BTU 6,00
<br />New Install, Floor Furnace 600
<br />Replacement Floor F-rnace 6.00
<br />New Install,, Suspended Heater 6,,00
<br />Replaceme,n,t Suspended Heater 600
<br />New Install. Wall Heater 6.00
<br />Replacement Wall Heater 600
<br />New Floor Mounted Unit Heater 6,,00
<br />Replace Floor Moun,ted Unit Heater 6.00
<br />Boil~,r(Compr. 3 hp, 100,000 BTU ........ 6,,0,.0, ....
<br />Boiler/Compr. 15 hp 500 000,,,~TU 1,,'70
<br />Boiler/Compr,, 30 bp, 1,000,000 BTU 15,,00
<br />Boiler/Oompr,,,50 hP, 1,750,000 BTU 22,,50 ....
<br />BoilerlCompr over 5,0., hp, 1,750,000 BTU 37,50
<br />Air H,~.ndllng 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 />Ex, h,a...ust System Commercial ....... 450 ,..
<br />Hood and Exhaust Commercial 450
<br />Domestic T~,pe Incinerator & Wood Stoves X ' , 7.50 7,50
<br />
<br />Commercial or Indq~,~,,E,!,al Incinerator 30.00
<br /> Gas Connection Without Appliance (1 to 4 each) 2,00
<br /> Over 4- $800 PI~ '~acil A~ditlonal ,,50
<br /> Appliance or Accessory to An HeAtln or
<br /> Corn for~ Cooling System Not ~Yovered ~?bove 4,50
<br />
<br />Approved By:
<br />Date:
<br />
<br /> FEE $ 17.50
<br />~/'~ SURCHARGE $ 70
<br />~;;'2 ~ ~2 ,,19~ TOTAL $ 18.20 .....
<br />
<br />I agree to instal/according to the submitted plans and specihcations~ the laws of the State of Oregon end the Ordinances of
<br />Marion County,, Permit expires if work not commenced within 120 days, I further expressly warrant that I comply with the provi-
<br />sions of ORS 701005 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 /> ) I am performing work on a. pr~e~oerty I own or Occupy
<br /> Other (please specify)
<br />SIGNATURE OF APPLICAN~
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