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fiOR OFFICE USE ONLY <br />eceived by: <br />ate: <br /> <br /> MECHANICAL PERMIT APPLICATION <br /> P/ease complete ali Sections, I through <br /> <br />MARION COUNTY BU][L][HNG INSPECTIOiS[ .~' <br /> <br /> Salem, Oregon 97301 [.[ ~/ LJ <br /> <br /> Code-A.Phone: 5Sg-7904 <br /> wx: ~s-~s Date: ~AR{ON ~O~NI~ <br /> BUILDING INSff~C~i IUN <br /> Issued by: <br /> <br />lOCATION OF INSTALLATION <br /> <br />iP~ A~ NON-~NS~L~ AND NON-~E~NDAB~ AND <br />~PI~ IF WO~ 1S NOT STAR~D ~ 1~0 DAY~ OF ISgUANC~ <br /> OR IF WOrK I$ SUSPENDED FOR 180 DAY& <br /> <br />2A, CONTP-~cToR INS"~ALLATION ONLY <br /> <br />Co.u=,°. R ;, <br /> <br />Contraotor's License No. <br /> <br />Coatractoes BoaM Peg. No. <br /> <br /> FOR OWNER INSTALLATIONS <br /> <br />Mailing Address <br />Ci¥Sme/Zip <br /> <br />Phone <br /> <br />The installation is being made on poapeay I own which is not intended for sale, <br />lease, or treat. <br /> <br /> 3. PLAN REVIEW SECTION <br /> <br />We will provide plan review so.ice if you complete Section <br />5B and submit two (2) setz of plans and specifications with <br />this application, <br /> <br />This optional plan rev/ow 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 />MC' 15-41 <br />Rev, 2192 <br /> <br />RESIDENTIAL [] COMMERCIAL [] <br /> <br /> USE OF STRUCTLqLE: <br /> <br /> NEW [] ALT~TfON [] ADDITION [] ~L~ON ~ <br /> <br /> NO. x ~ = SUM <br />B~ ~E $10.00 <br /> <br />Forced Air Ft~naee <br />I00,000 BTU or less <br />Over 100,000 BTU <br /> <br />$ 6,00 <br /> <br />7,50 <br /> <br />Floorlh~.ma~e __ $ 6.00 <br />Smpended Heater __ $ 6.00 <br />Wall Heater __ $ 6.00 <br />Floor Mounted Unit Heater __ $ 6.00 <br /> <br />Heat Pump or Air Conditioner <br /> Up to 3 Ton <br /> 3 Ton to 15 Ton <br />~v~perative Cooler <br />Exhaust System, Commercial <br />Hood and Exhaust, Commercial <br /> <br />6.00 <br />$11.00 <br />4.50 <br />4.50 <br />4.50 <br /> <br /> 4.50 <br /> <br /> 3,00 <br /> 3,00 <br /> 7,50 <br /> 7.50 <br /> <br />Domestic Ra~lge Hood <br />Domestic Exhaust Fans <br /> and Dryer Vents <br />Fire Damper <br />Wood Stove <br />Furnace Ducts (Alteration, l~xtcnsion) <br /> <br />Commercial or industrial Inei~erat or <br /> <br />__ $30.00 <br /> <br />Gas Water Heater (relocation <br /> or replacement) <br />~as CoauecQon w/o Appliance <br /> --per outlet, up to 4 <br /> --ovor 4, $8.00 pl~ ea. <br /> additional <br /> <br />For the Installst~on, Reloeatlen <br /> or Replacam(mt of ed. Appliance <br /> Vent not ~cl~ed ~ ~ <br /> Appli~ ~it, <br /> <br />Other (as required by Building Official) <br /> <br />__ $ 7.50 <br /> <br />__ $ 2.00 <br /> $ .50 <br /> <br />$ 3.00 <br /> <br />FEES <br /> <br /> <br />