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FOR OFFICE USE ONLY <br />Received by: <br />Date: <br /> <br />MAR]ON C~OUNTY BUILDING INSPECTION <br /> <br />MECHANICAL PERMIT APPLICATION <br />Please complete all Sections, I through <br /> <br />1. LOCATION OF INSTALLATION <br /> <br />220 High $ffeet NE <br />Salem, Oregon 97301 <br /> <br />Phone 588-5147 $:00 am,- 4:30 <br /> Code-A-Phonc~S88.7904 <br /> ~AX:SSg-7948 <br /> <br />Directions <br /> <br /> I <br />PERMITS ARE NON-TRANSFERABLE AND NON-REFUNDABLE AND I <br />EX PaLE IF WORK IS NOT STARTED WIT~tlq 180 DAYS OF ISSUANCE <br />OR. IF WORK IS SUSPENDED FOR 180 DAYS, <br /> <br />CA. CONTRACTOR INSTALLATION ONLY <br /> <br />]lobNo, <br /> <br />2B, FOR OWNER iNSTALLATIONS <br /> <br />Ci~/Stste/Zip <br /> <br />The inl~lallallon is being made on pmper~y I own which is not intended for sale, <br />lea,se, or rent. <br /> <br />We wi provide pl~ re~ew se~ice if you complete Section <br />5B ~ submit ~o (2) se~ of plus ~d specifimtions ~ <br />· is application. <br /> <br />This optional plan review program does not suspend the <br />required submission of plans, and specifications when required <br />by *he Oregon Structural Specialty Code, Chapter 53, <br /> <br />~lU IJ-41 <br />1~, 2/92 <br /> <br />COUNTY <br /> <br />RESID~NTIALg'~~'''~ COMNIE~CIAL ~ <br /> <br /> USE OF SlgU~: <br /> <br /> ~,~w [] ALT~XnON [] A~DInO~ ~] ~,ELC~O~ [] <br /> <br /> NO, X FEE = SUM <br />EASE ]~,E $IO.0~ <br /> <br />Forced Air Puznace $ 6.00 <br />100,000 BTU or less <br />Over 100,000 BTU -- $ 7,50 <br /> <br />FloorFuma~e __ $ 6.00 <br />SUSl~m4ed Heater __ $ 6.06 <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 1S Ton <br />Evaporative Cooler <br />Exhaust System, Commercial <br />Hood and Exhaust, Commercial <br /> <br />Domestic Range Hood <br />Domestic Exhaust Fa~s <br />and Dryer Vents <br />Fire Damper <br />Wood Stove <br />Furnace Ducts (Alteration, Extension) __ <br /> <br />Commcrcial or Industrial Incinerator <br /> <br />Gas Water Healer (relocation <br /> or replacement) <br />Gas ConJaection w/o Appliance <br /> --per outlet, up to 4 <br /> --over 4, $8,00 plus ca. <br /> additional <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 />__ $30,00 <br /> <br />__ $ 7.50 <br />__ $ 2.00 <br />__ $ .50 <br /> <br />For the Installation, Relocation <br /> or Replacement o£ea. Appliance <br /> Vent not included in an <br /> Appliance permit. <br /> <br />Other (as required by Building Official) <br /> <br />__ $ 3,00 <br /> <br />5. FEES <br /> <br /> . Rein~Jon F~ ($25,00) <br /> <br /> TOTAL AMOUNT D~JE <br /> <br /> Receipt No, <br /> <br /> <br />