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Received
<br />Date:
<br />
<br />MARION COUNTY BUILDING INSPECTION
<br />
<br /> 20 High Street NE
<br /> '- Salem, O~gon 97,301
<br />
<br /> Phone 588-51e7
<br /> Code-A-Phone 4:,30 RM. - 8:00 A.M.
<br />
<br />MECHANICAL PERMIT APPLICATION
<br />
<br /> I IAt ION COUNty
<br />BUILDING iNsp£¢TiON
<br />
<br /> Property Owner; Phone; .......... Mailing Address:
<br /> Randy Fultz
<br /> Job Address: Siie NO,: ............ Cross Street: .....
<br /> 5953 Walina Ct,,,~,,,,,,,S,E'
<br /> Mechanical installer: Phone: .... Address;
<br /> Montaq of Salem Inc.m 585 6396 101 U~ion St, NE
<br /> Home Builder% Registration N'6'Z:
<br /> 53~_
<br /> Rasidentlakxx~ Commercial: "UseofBuildJng:
<br /> New: [] ' Alteration; [] Addition:'"'l-I ' Relocation; [] OccupancyChasge; [] -----
<br />XX,XX ............
<br />
<br /> NO. FEE AMOUNT
<br />Base Price 10.00
<br />Fomed ~,i~ furnace lOO o00 BTU o'r less 6.00
<br />Forced air furnace, over 100,000 BTU 7,50
<br />Floor Furnace 6,00
<br />Suspended Heater 6.00
<br />Wall Heater 6,00
<br />Floor Mounted UnJ't Heater 6,00
<br />Heat Pump I 6,00
<br />Air Handling Unit to ~10000 cu, ft, 4,50
<br />Air Handling Unit over, 10,000 cu, ft, 7,50
<br />Evaporative Cooler 4.50
<br />Exhaust S?.~t,e m Commemial 4,50
<br />_H,ood and Exhaust Commereia'l 4.50
<br />Domestic Range Heeds ~..,,, , 4,50
<br />Domestie Exhaust F~ns & Dryer vents ,, , 3 3.00
<br />For pre-installation or installation
<br />of each wood stove 7,50
<br />
<br /> NO. FEE AMOUNT
<br />Commercial or Industrial Incinerator 00,00
<br />Fire Damper ;3.00
<br />Gas Water Heater 7,50
<br />For each gas piping system'ef up to .......
<br />4 outlets.!,.~inimum tee 2.00
<br />For each gas pip;rig system of 5 or more ....
<br />outlets, per o~tlet .50
<br />For the installation, relocation or
<br />replacement of each appliance vent
<br />not included in an appliance permit 3,00
<br />ApCasce or accessory to any heating or
<br />Comfort cooling,system not covere,d 4,50
<br />Other (as per Mechanical, Code):
<br />On-Site Technical Review
<br />(Apply.,,~t Marion Co. only)
<br />ReJnspectlon Fee 15.00
<br /> FEE ~
<br /> STATE SURCHARGE
<br /> PLAN REVIEW FEE $
<br /> INVESTIGATION FEE $
<br /> FLEET SURCHARGE $
<br /> CITY FEE $
<br /> TOTAL
<br />
<br />Please return COMPLETE APPLICATION with the indicated fee,
<br />
<br />(X) lemareglsteredbuilderOR( )theauthorizedrepresentati,,eof S]GNATUREOFAPPLICANT: ,
<br />
<br />( ) Other ,
<br />
<br />MC 15-41
<br />ReV, 3/87
<br />
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