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IFOR OFFICE USE <br /> ONLY <br />Received by: <br /> Dat~: ~ <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> <br />IMECHANICAL PERMIT APPLICATION <br />PJease complete all Sections, 1 through 5 <br /> <br />220 High Street NE <br />Salem, Oregon 97301 <br /> <br />phone 588-5147 S:00 a.m.- 4:30 p.m. <br />Code-A-Phone:SSS-7904 <br />FAX:588-7948 <br /> <br />SITE #: <br /> <br />Permit No, <br /> <br />Issued by: ~ <br /> <br /> LOCATION OF INSTALLATION <br /> <br />'ob^dd,o <br /> <br />PERMITS AI~E NON,TRANSFERABLE AND NON-R.~FUNDABLE AND <br />EXPIRE IF WORK IS NOT STARTED V~THIN 1 $0 DAYS OP ISSUANCE <br />OR IF WORK iS SUSPENDED FOR 180 DAYS. <br /> <br /> ~'~/CONTRACTOR INSTALLATION ONLY ,,, <br /> I Phone ~ ~q'/~-~O <br /> <br />Contraetogs Board Reg. No, [ Job No. <br />Contractor's Signature: <br /> <br />2B, I~)R OWNER INSTALLATIONS <br /> <br />Th~ it~$tallalion is helnS ma~p eTty ! owu which ia not intended for *ale, <br /> <br />Ov~ofs Signature . , ................. <br /> 3. PLAN REVIEW SECTION <br /> <br />RESIDENTIAL [] COMMERCIAL <br /> <br />%]SB OF STEUCTU~: <br /> <br />NEW~"'I ALTERATION [] ADDITION [] II,LOCATION [] <br /> <br />BASE FEE $I0,OO <br /> <br />Forced Air Furnace $ 6.00 <br />100,000 BTU or less <br />O~er 100,000 BTU -- $ 7.50 <br /> <br />Floor ~mace __ $6,00 <br />Suspended Hceter __ $ 6,00 <br />Wall Hcater $ 6,00 <br />Floor Mounted Unit Heater __ $ 6.00 <br /> <br />Heat Pump or Air Conditioner <br />Upto 3 Ton -- $6,00 <br />3 Tanto 15 Ton $11.00 <br />Evaporative Cooler __ $ 4.50 <br />Exhaust System, Commercial __ $ 4.50 <br />Hood a~d ~Sxhaust, Commercial __ $ 4.50 <br /> <br />Domestic Range Hood __ $ 4.50 <br />Domestic l~xhaust Fans <br />and Dryer Vents [ $ 3,00 <br />Fire Damper __ $ 3.00 <br />Wood Stove $ 7.50 <br />Pernace Ducts (Alteration, Extension) __ $ 7,50 <br /> <br />Commercial or Industrial Incinerator __ $30.00 <br /> <br />Gas Water Heater (~locatien <br />orrsplacemem) __ $ 730 <br />Craz Connection <br />--per outlet, up to 4 __ $ 2.00 <br />--ove~ 4, $8.00 plus ca, <br />additional $ .50 <br /> <br />For the Installation, Relocation <br /> or Replacement of ca, Appliance <br /> Vent not included in an <br /> Appliance l~rmlt. <br /> <br />Other (as required by Building Official) <br /> <br />__ $ 3.00 <br /> <br />We will provide plan review service if you complete Sectiva <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 />Rev. 10~92 <br /> <br /> <br />