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o ic, us,' b, YI <br />Received by; <br />Date: . <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> <br />MECHANICAL PERMIT APPLICATION <br />Please complete all Sections, 1 through 5 <br /> <br />220 High Street NE <br />Salem, Oregon 97301 <br /> <br />Phone 588-5147 $:00 a.tm- 4:30 p.m SIT~ 1S': <br />Code-A-Phone: 588-7904 <br />FAX: $88-7948 D~[O: <br /> <br />l. I,O~ATION 01~ INSTALLATION <br /> <br />PERMITS APE NON-TRANSFERABLE AND NON-REFUNDABLE AND <br />.EXPIRE IF WORK IS NOT STARTED WITHIN l S0 DAYS OF ISSUANCE <br />OR. IF WOP. K 15 SUSPENDED FOR I$0 DAYS- <br /> <br /> :,. CON,rRA~TO~,N~*Lr, T,;ON O~L~ . <br /> <br />Co~m~toe~ [.iccn~ No. ,, ] <br /> <br />~B, FOR OWNER INSTALLATIONS <br /> <br /> ,, Phoae i <br />Mailing Add,ss <br /> <br />City/State/Zip <br /> <br />The installation is being mIale on property I own which is not intended for sale. <br /> <br />Ow~c?s Signature <br /> <br /> 3. PLAN REVIEW SECTION <br /> <br />permR No. <br /> <br />issued by: <br /> <br /> P~ S IDF2qTIAL ~.. COMIV~RCIAL [] <br />BASE ~ <br /> <br />$10.00 <br /> <br />Fo~¢d Air Pumac~ $ 6.00 <br />100,000 BTU or less <br />Over 100,000 BTU -- $ 7.50 <br /> <br /> FloorFt~aace __ $ 6.00 <br /> Suspended Heater $ 6.00 <br /> Wall Heater __ $ 6.00 <br /> Floor Mortared U~t I4~ater __ $ 6,00 <br />Heat Pump~ Air Confiifion~ ~ <br />Up to 3 Ton ~ $ 6~00 <br />~3 Tonto 15 Ton / $I 1.00 <br />~poratiw Cool~ $ 4.50 <br /> E~t S~, C~ ~ $ 4.50 <br /> ~ood ~d ~t, C~i~ __ $ 4.50 <br /> <br /> Domestic R~g¢ Hood __ $4.50 <br /> Domestic ~t F~s <br /> <d ~ V~ts __ $ ZOO <br /> F~ Dm~ ~ $ 3.00 <br /> Wood Steve __ $ 7.50 <br /> ~e ~ts (~t~atio~ ~t~inn) __ ~.50 <br /> <br />Gas Water Heater (relocation <br />or replacecaent) __ $ 7.$0 <br />Gas Connection <br />--per outlet, up to 4 __ $ 2.00 <br />--over 4, $8.00 plt,~ ca. <br />additional $ .$0 <br /> <br />For the Installation, Relocation <br /> or Replacement ofea, Applianea <br /> Vent not included in a~ <br /> Appliance pea'mit. <br /> <br />Other (as required by Building om¢inl) <br /> <br />__ $ 3.00 <br /> <br />We will provide plan review service if you complet~ Section <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 />requited submission of plans, and specifications when required <br />by the Oregou Structural Specialty Code, Chapter 53. <br /> <br />MC 1.%41 <br />Rev. §/~.~ <br /> <br /> <br />