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IFOROi~ICF~USE ONLY[ , M~e..IO?VCGUNTY B"O'IgD~ION_ <br />Received by: D, <br /> <br /> ~one 588-5147 8:00 a.m. ~ 4:30 p.m. <br /> <br /> MECHANICAL PERMIT,A~PLiCATION ] F~: ~-~a Date <br /> Please complete all Sections, I through5,[ ' , : : ' I~ued <br /> <br />1. LOCATION OF INSTALLATION <br /> <br />PERMITS ARE NON.TRANSFERABLE AND NON.REFUNDABLE AND <br />EXPIR. E he WORK tS NOT STARTED WITHIN 180 DAYS OF iSSUANCE <br />OR IF WOKK IS SUSPENDED FOP. 180 DAYS. <br /> <br />2A, CONTRACTOR INSTALLATION ONLY <br /> <br />CollUactofs Board Rcs,. No. ~'-~/' <br />Contractor's Signatare: ~ <br /> <br />2B. FOR OWNER INSTALLATIONS <br />Propcr~y Ownee <br />Mailing Addre,~s Phone <br /> <br />City/State/Zip <br /> <br />The iuatallatlou is being made on pmp~t~y I own whleh is not intended ~or sale, <br /> <br />Owners Signature <br /> <br /> 3, PLAN REVIEW SECTION <br /> <br />NEW~kLTERAT10~ [] ADDITION ~'~ I~ELOCATION [] <br /> <br />NO, X FEE = SUM <br /> <br />BASE FEE <br /> <br /> $10.00 <br /> <br /> Forced Ah- Furnace ~ $6.00 <br /> 100,000 BTU or less <br /> Over 100,000 BTU -- $ 7,50 <br /> <br />l;!oor Furnace $ 6.00 <br />Suspended 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 J $ 6,00 <br />3 Torito 15 Ton -- SILO0 <br />Evaporative Cooler $ 4.50 <br />Exhaust System, Commercial __ $ 4,50 <br />Hood and Exhaust, Commercial __ $ 4,50 <br /> <br />Domestic Range Hood S 4,50 <br />Domestic Exhaust Falls <br />and Dryer Vents __ $ 3,00 <br />Fke Demper __ $ 3,00 <br />Wood Stove $ 7.50 <br />Furnace Ducts (Alteration, Extension) __ $ 7.50 <br /> <br />Comme~ial or Industrial I~cincrater __ $30,00 <br /> <br />Gas Water Heater (relocation <br />or replacement) __ $ 7.50 <br /> <br /> --m outlet, uvto 4 / $ 2.00 v? &o <br /> --over 4, Sg.00 pl~ ca. <br /> additional $ <br /> <br />For the Installation, Relocation <br /> or R~lacement of ea. Appliance <br /> Vent not included m an <br /> Appliance permit, <br /> <br />Other (as requited 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 />ti]is 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 />O0 <br /> <br />Reu. lO/92 <br /> <br /> <br />