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Received <br />Date: _ <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> ~enator Bldg. No. 22~ <br /> ~2~ Hlglt St~st NE <br /> ~alem, O~gen 97'301 <br /> Ph~me 688-~147 <br /> <br />'MECHANICAL PERMIT APPLICATION <br /> <br />pr arty Owne~-'i Phone: Mailing AddreSs: ' _ <br /> <br />J$~Addmss: ' ' Sits No~i ' Cross arrest; " q~3~ <br />H0m~ BUilder~ Registration N0,: ~ / <br /> <br />New: ~ Alterafion:~ ,] Addition: ~ Relocation: ~ "~cupan~Cha~ge: ~ <br /> <br /> NO, FEE AMOUNT <br />B~se Price / 10.00 <br />Forced alt furnace 100,000 BTU or lass / 6.00 ~>,~> <br />Forced air furnace over 100,000 I~-U 7.50 <br />Floor Furnace 6.00 <br />S~r~Spended He.er 6,00 <br />Wall Heater 6,00 <br />Fl~or. Masqted 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 System CornmercMI 4.50 <br />Hood and Exhaust Comrnerclal 4.50 <br />Dornastic Range HOOds 4,50 <br />Domest o Exhasst Fans & Dryer Vents 3,00 <br />For pm-inststlatlon or InstallaUon · <br />of each wood stove 7,50 <br /> <br />Cornme~ial or Industrial Incinerator <br />Fire Damper <br /> <br />For each gas piping system of up to <br /> <br />For each gas piping syatsm of 5 or more <br /> outlet~ per outlet <br />For the InststlatJon, raloce§on or <br /> rep~acemeot of es, ch ~.pp~an~e vent <br />not included in an appliance permit <br />Appliance or accessory to any heating or <br /> Comfort cooling syst~em not covered <br />)ther (as per Mechanical Code): <br />On-Site Technical Review <br /> (Apply at Marion Co. only) <br />Relnspe.?,t~on Fee <br /> <br /> FEE <br />STATE SURCHARGE <br />PLAN REVIEW FEE <br />iNVESTIGATION FEE <br />FLEET SURCHARGE <br />CITY FEE <br /> TOTAL <br /> <br />AMOUNT <br /> <br /> Please return COMPLETE APPLICATION with the indicated fee. <br /> <br />~ ) lam pedormlng w0rk on a pmpe~ own or occupy. '. <br />( ) I ';ma registered ~uJMer OR (~JJ:~ authorized rnpresentallve of SIGNATURE OF APPLICAN <br /> <br /> <br />