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FOR OFFICE USE ONLY <br />Received by: <br />Date: ,, <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> <br /> 220 High S~et NE <br /> Salem, Oregon97301 <br /> <br />Phone 588-5147 8.~0 Mm, - 4:30 g,m. <br />FAX:SSS-7948 <br /> <br /> Code-A.Phone: 588.7904 <br />MECHANICAL PERMITAPPLiCAT]ON 5 <br />Please complete all Sections, I through <br /> <br />SITE #: permit No, <br />Date: <br />Issued by: <br /> <br /> 1. LOCATION OF INSTALLATION <br /> <br />dobAaarq~ 170 Detroit Ave. <br /> <br />]ity Detroit. OR <br /> <br />I cros,s St. <br /> <br />?ER2vlITS ARt3 NON-TRANSFERABLE AND NON.KEFUNDABI~ AND <br />~ IF WO~ IS NOT STARED ~ 180 DAYS OF ISSU~CE <br />ORIF WO~ IS SUSP~DED FOR 18o DAYS. <br /> <br /> 2A. CO~T~CTOR I~$TAL~TION ONLY <br />~ntfOC~t Sal~ Htg. & Sht. Mtl,I~e~o~ 581-1536 <br /> <br /> 1-- <br /> <br />Board Rc~, :No. 1505 [/ob No- <br /> <br />Contxactor's Signatu~: <br /> <br /> ~B. FOR OWNER iNStALLATIONS <br /> <br />Mailing Add,ss <br /> <br />City/Stale/Zip <br /> <br />Owilet~s SJgnamt~ <br /> <br />3, PLAN REVIEW SECTION <br /> <br />We will provide plan review service if you complete Section <br />5B and submit two (2) ~ts of plans and ~pecifications with <br />this application. <br /> <br />This optional plan review progrmn does nOt ~uspend the <br />requi~ed submission of plans, and specifications when required <br />by the Oregon Structural Specialty Code, Chapter 53. <br /> <br />tic 15-41 <br />Rev, 5/93 <br /> <br />KESiDENTIAL [] COMMERCIAL [] <br /> <br /> USE OF STRU~: <br /> NEW ~ ALTERATION [] ADDITION [] RELOCATION <br /> <br />BASE l~g <br /> <br />Forced Air Fum~e <br />100,000 BTU or le88 <br />Over I00,000 BTU <br /> <br />Floor Pamace <br />Suspended Heat~ <br />Wall Heater <br />Floor Mounted Unit Heater <br /> <br />HeEt Pump [] / Air Conditioner [] <br /> Up to 3 Ton <br /> 3 Tonto 15 Ton <br />Evaporative Cool~ <br />Exhauat Syst~an, Comm~clal <br />Hood amd Exhaust, Comm~ial <br /> <br />Domestic Range Hood <br />Domestic Exhaust Fans <br />a~d Dryer V~ts <br />Fire Daml~T <br />Wood Stove <br />Fumace Ducts (Alt~ation, ~xtension) __ <br /> <br />Commercial or lnd~trlal lnclnmator <br /> <br />6.00 <br />7,50 <br /> <br />6.00 <br />6.00 <br />6.00 <br />6.00 <br /> <br />6.00 <br />$II.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 /> $4,50 <br /> <br />__ $30,00 __ <br /> <br />Gas Water Heater (relocation <br />or replacement) <br />Gas Connection <br /> --lx;r outlet, up to 4 <br /> --over 4, $$.00 plus ea. <br /> additional <br /> <br />7.50 <br />2.00 <br />.50 <br /> <br />For the I~tallation, Relocation <br /> or Replacement ofen. Appliance <br /> Vent not mol~ ~ ~ <br /> A~li~ce ~it. <br /> <br />~ (~ ~ff~d ~ BuiM~g Offio~) <br /> <br />__ $ 3,00 <br /> <br />5. FEES <br /> <br /> Suba~l <br /> <br /> Rcgeipt No, <br /> <br />s 18.qO <br /> <br />$10,00 <br /> <br /> 6:00 <br /> <br />2.00 <br /> <br /> <br />