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]F~R OFFICE USE ONLY <br />IReceived by:. <br />~D~: ,,, <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> <br />COUMUNITY DEVELOPMENT CENTER <br />285 Chlffch St. NE - Room 132 <br /> Salem, Oregon 97301 <br /> <br /> Code. A-Phone: 585-7904 <br />MECHANICAl-' pERMIT APPLICATION I <br />Please complete all Sections, I through 5 <br /> <br />Phouc 588-5147 S,-00 a.m. ~ 4:30 <br /> F&X'- $$g-794S <br /> <br />SITE #: <br />Date: <br /> <br />Issued by: <br /> <br />FEILMITS A RE NON-TR.ANSFERA~LE; AND NON.REFUNDABLE AND <br />EXPIg3~, IF WORK. IS, NOT STAP, TE, D WITI, tlN lB0 DAYS OF ISSUANCE <br />OR IF WORK IS SUSPENDED FOR 180 DAYS. <br /> <br /> 2~.~ CONTRACTOR INSTALLATION ONLY <br /> <br />,on,factor ~ <br /> ,' / "< <br /> <br /> FOR OWNER INSTALLATIONS <br /> <br />Mailil~s Address <br />CRy/State/Zip <br /> <br />Tnt; iAstallatioll i~ being m ',2~1 ¢ on property t own which is not intea~ed for sale, <br /> <br /> 3. PLAN REVIEW SECTION <br /> <br />We wilt provide plan review service if you complete Sectto~ <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 />Forced )dr Furnace <br />100,000 BTO or <br /> Over 100,000 BTU <br /> <br />Floor Furnace <br />Suspended Heater <br />Wall Heater <br />Floor Mounted Unit Heater <br /> <br />Hast Pump [] / Air Cooditioner [] <br /> Up to 3 Ton <br /> 3 TanIo 15 Ton <br />Evaporative Cooler <br />]Sxlmust System, Commercial <br />!-Iood and Exhaust, Commercial <br /> <br />Domestic Range Hood <br />Domestic F~lmust Fans <br /> and Dryer ¥~ts <br />Fire Damger <br />Wood Stove <br />Furnace Ducts (Alteration, Extansian) <br /> <br />Commercial or Industrial Incinerator <br /> <br /> $ 6.00 <br /> <br />- $7.50 <br /> <br /> $ 6.00 <br /> $ 6,00 <br /> $ 6.00 <br /> $ 6,00 <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 /> $4.50 <br /> <br />$30.00 <br /> <br />Gas Water Heater (relocation <br />or rephve, m, ealt) <br />~a~ Colmectiela: '. <br /> --per outlet, up tO 4 <br /> <br /> additional <br /> <br />__ $ 7,50 <br /> $ 2.00 <br /> $ ,50 <br /> <br />For the Installation, Relocation <br /> or Replacement of ea. Appliance <br /> Vent not included in an <br /> Appliance permit. <br /> <br />Other (as required by Building Official) <br /> <br />., $ 3.00 <br /> <br /> FEES <br /> <br /> Subtotal <br /> <br />D, Reinslmct ion Fee ($ 2,~ ,00) <br /> <br />S <br /> <br /> <br />