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220 <br /> Salem, Oregon 97301 p ~ <br /> <br />MECHANICAL PERMIT APPLICATION ] <br />Please complete all Sections, 1 though 5 I <br /> <br /> 4 FEE~H~ULE(~pI~enter~I~AI ~) <br /> <br /> ~SIDE~AL ~ CO~RCI~ <br /> <br />Cross St, <br /> <br />Dire~ions <br /> <br />PERMITS ARE NON-TRANSFERABLE AND NON-REFUNDABLE AND <br />EXPIR~ IF WOl~g, IS NOT STAR, TI~D WITHIN IS0 DAYS OF ISSUANCE <br />OR IF WORK IS SUSPENDED FOR lSO DAYS. <br /> <br />2A. CONTRACTOR INSTALLATION ONLY <br /> <br /> FOR OWNER IN~ALLATION$ <br /> <br />Property Owner <br />Mailing Address Phone <br />CJty/Stae/Zip <br /> <br />The it~stallalion is being made on prop¢0y I own which is not intended for ~ale, <br />lease, or rent, <br /> <br />Owners Signature <br /> <br /> 3, PLAN REVIEW SECTION <br /> <br /> USE OF STRUCTURE: <br /> <br /> NO. X FEE - SUM <br />BASE F~E $10.00 <br /> <br />Forced Ah' Futm~e $ 6,00 <br />100,000 BTU or less <br />Over 100,000BTU -- $ 7.50 <br /> <br />Floor Furnace __ $ 6,00 <br />Suspendod Heater __ $ 6,00 <br />Wall Hea~r $ 6,00 <br />Floor Mounted Unit I-l~ater $ 6~00 <br /> <br />Heat Pump or Air Conditioner <br />Up to 3 Ton .--~ $ 6,00 <br />3 Ton to 15 Ton $11.00 <br />Evaporative Cooler __ $ 4.50 <br />Exhaust System, Commercial __ $ 4,50 <br />Hood end Exhaust, Commercial __ $4,50 <br /> <br />Domestic l~ge Hood __ $ 4,50 <br />Domestic Exhaust Fans ...... <br />and Dryer Vents __ $ 3.00 <br />Fire Damper __ $ 3,00 <br />Wood Stove $ 7,50 <br />Furnace Duc~s (Alteration, Extension) __ $ 7,50 <br /> <br />Commercial or I~dustrial Inciaexator __ $30.00 <br /> <br />Gas Water Heater (relocation <br />or replacement) __ $ 7.50 <br />Gas Connection w/o Appliance <br />--per outlet, up to 4 __ $ 2,00 <br />--over 4, $8.00 plus ca. <br />additional $ .50 <br /> <br />For the Installation, Relocation <br /> or Replacemant of ea. Appliance <br /> Vent not mcinded in an <br /> Appliance permit. <br /> <br />Other (as required by Building Official) <br /> <br />__ $ 3,00 <br /> <br />We will provide plan review service if you complete Section <br />5B and submit two (2) sets of plans and specifications with <br />this application. <br /> <br />This optional plan review program does not suspend the <br />required submission of plans, and specifications when required <br />by the Oregon Structural Specialty Code, Chapter 53, <br /> <br />2/92 <br /> <br /> <br />