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FOR OFFICE USE ONLY <br />Received by: <br />Date:___ <br /> <br />MECHANICAL PERMIT APPLICATION <br />Please complete all Sections, 1 through 5 <br /> <br />phone 5S8-S 147 S;00 a-re. ~ 4;30 p,m, <br />Code-A-Phone: 588-7904 <br /> I FAX: 588-7948 <br /> <br />MARION COUNTY BUILDING INSPE~I~N,i,~d ~ ~ ~ ~ ti ~'~ Iii! <br /> 220 High Street NI~ <br /> Salem, Oregon97301 ~J~ ] ~ ]9~,~, <br /> Perm~ No, <br /> SITE :MAR'I'bN COUNIY <br /> D U LD NG N?ECT!0N <br /> <br />Issued by: <br /> <br />1- LOCATION OP INSTALLATION <br /> <br />PERMITS APSE NON.TRANSFERABLE AND NON.REFUNDABLE AND <br />EXPJRF, IF WOP. J{ IS NOT STARTED WITIIIN 180 DAYS OF ISSUANCE <br />OR. IF WORK IS SUSPENDED FOP. 180 DAYS. <br /> <br /> 2A. CONTRACTOR INSTALLATION ONLY <br /> <br />ProgeaY Owner <br /> <br />2B, FOR OWNER INSTAI,LATIONS <br /> <br />No, <br /> <br />P~opcay owner <br />: Mailing Add~as I Phone <br /> CJly/State/Zip <br /> <br /> Th~ in~tallation is h~ing made on property I own which is not inten4ed for aal¢, <br /> <br /> OwneFs Signatur~ <br /> <br /> S, PLAN R£VIEW SECTION <br /> <br />RESIDENTIAL [] COMMERCIAL <br /> <br /> USE OF STP, UC'IIJI~: <br /> / <br /> NEW [~ ALTEKATION [] ADDITION [~elLELOCATION ~- <br /> NO, X FEE = SUM <br />BASE I~E $10,00 <br /> <br />Fomed Air FUrnace $ 6.00 <br />100,000 BTU or less <br />Over 100,000 BTU -- $ 7.50 <br /> <br />Floor Furnace __ $ 6,00 <br />Suslx:nded Heater __ $ 6,00 <br />Wall Heater __ $ 6,00 <br />Floor Moanted Unit Heater __ $ 6.00 <br /> <br />Heat Pump or Ail' CoRditinncr <br /> Up to 3 Ton <br /> 3 Ten to 15 Ton <br />Evaporative Cooler <br />Exhaust System, Commercial <br />Hood and Exhamqt, Commercial <br /> <br />Domestic Range Hood <br />Domestic Exlmust Fans <br />and Dryer Vents <br />Fife Damper <br />Wood Stove <br />Furnace Ducts (Akeration,/~xtenslon) __ <br /> <br />Commercial or Industrial Incinerator <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 />Gas Water }luster (relocation <br />or replacement) <br />Gas Conno:tian <br /> --per outlet, lip to 4 <br /> --over 4, $8.00 plus es, <br /> additional <br /> <br />__ $ 7.50 <br /> $ 2,00 <br /> <br />-- $ ,50 <br /> <br />For the Installation, R.¢locatian <br /> or Replacement of ca, Appliance <br /> Vent not included in an <br /> Appliance permit, <br /> <br />Other (as r*quir~d by Building Official) <br /> <br />__ $ 3,00 <br /> <br />We will provide plan review service if you complete Section <br />5 B ~md 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 Stntctural Specialty Code, Chapter 53. <br /> <br /> dC' <br />Rev. 10/92 <br /> <br />5, FEES <br /> <br /> A2. Add 5% stu~harge (.05 X A 1 ) <br /> <br />$ /j, ov <br /> <br />$ <br /> <br />S <br /> <br /> <br />