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MECHANICAL PERMIT APPLICATION <br />Please complete afl Sections, I through 5 <br /> <br />MAR/ON COUNTY BUILDING INSPECTION <br /> <br />220 High Slx. et lq~ <br />'Salem, Oregon 97301 <br /> <br />Phoee 588-5147 g:00 a~m, - 4:30 p,m, <br />Cod~-A-Phota¢: 588-7904 <br /> FAX: 555-7948 <br /> <br />SiTE #: <br /> <br />Date; <br /> <br />Issued by; <br /> <br /> 1. LOCATION OF INSTALLATION <br /> <br />city ' l e~ st. La_~ go~T <br /> <br />PERMITS ARE NON-TRANSFERABLE AND NON-REFUNDABLE AND <br />~XPIRB IF WORK IS NOT STARTED WITHIN 180 DAYS OF ISSUANCE <br />I,OR IP WORK IS SUSPENDED FOR ! $0 DAYS. <br /> <br /> 2A. CONTRACTOR INSTALLATION ONLY <br /> <br />Mailing Address <br /> <br />Property Owner ,,, <br /> <br />Coattactot~i License No, <br /> <br />IPhon¢ <br /> <br />Coatta,~toes Boaa/ReS, No. <br /> <br />FOR OWNER INSlOALLATION$ <br /> <br />Mailiag Address <br /> <br />City/Sta~/gip <br /> <br />We will provide plan review service if you complete Section <br />5B and submit two (2) sets &plans a~d specifications with <br />this application, <br /> <br />This optional pla~ review program does not respond the <br />n~quired ~ubmission of plans, and *pecificatioas when required <br />by the Oregon Slractural Specialty Code, Chapter 53, <br /> <br />~rC )5-41 <br />Rev. 2/92 <br /> <br />RESIDENTIAL [] COMMI~RCIAL ~] <br /> <br />BASE I~,E $10.00 <br /> <br />Forced Air !h,LmaCe $ 6,00 <br />100,000 BTU or less <br />Owex 100,000 BTU -- $ 7.50 <br /> <br />Floor Furnace __ $ 6,00 <br />Susp~aded Heater __ $ 6.00 <br />Wall Heater $ 6.00 <br />Floor Mouatod Unit Heater $ 6.00 <br /> <br />l~g PUmp 6r Air Condflioaar <br />Up to 3 Ton $ 6.00 <br />3 Ton to 15 Ton $11.00 <br />Evaporative Coolor ~ $ 4.50 <br />Exhaust System. Co~iai ~ $ 4,50 <br />Hood ~d E~a~t, Co~erei~ ~ $ 4.50 <br /> <br />Domestic R~ge Hood ~ $ 4.50 <br />Domegic ~m~ F~s <br />~d ~ V~ts ~ $ 3.00 <br />Fire Dm~ ~ $ 3,00 <br />Wood Stove ~ $ 7.50 <br />~e ~cts (~teration, ~sion) ~ $ 7.50 <br /> <br />Co~ial or ~d~tg~ ~c~ator $30,00 <br /> <br />Gas Water Heater (relocation <br /> or replacement) <br />Gas Cormectioa w/o Appliance <br /> --per oufle~, up Io 4 <br /> --over 4, $8.00 pl~ ~. <br /> ~dition~ <br /> <br />For the ~t~latiou, Relocation <br /> or Repla~ of~. Appli~ce <br /> V~I not ~cluded ~ ~ <br /> A~li~ce ~it. <br /> <br />~her Cs mq~ed by B~I~g <br /> <br />$ 7.50 <br /> <br />__ $ 2,00 <br /> $ .50 <br /> <br />$ 3,00 <br /> <br />A2, Add $% Surcharge (.05 gal) <br /> (Al ~ ,~S) ir r~quir~d <br /> <br /> <br />