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FOuR OF~iCE'USE"ONLY[ <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> <br />coMMUNITY DEVELOPMENT CENTER <br />285 Chumh SI, NE - Room 132 <br /> Salem, Oregon 97301 <br /> <br />Phone 5gS-5147 S:00 s~m. ~ 4:30 p.m, <br /> <br />G0d¢-A-Pl~one:5SS-7904 <br /> <br />MECHANICAL. PERMIT APPLICATION <br />Please complete all Sections, i through 5 <br /> <br />FAX:SSS-7048 <br /> <br />Date: <br /> <br />Permit No, <br /> <br />Issued by: <br /> <br />LOCATION OF INSTALLATION <br /> <br />pERMITS ARE NON.'ItLANSFERABLE AND NON.REFIJNDABLI~ AND <br />EXP~RI3 IF WORK IS NOT STAP. TgD WITHIN 1S0 DAYS OF ISSUAI~CI~, <br /> <br /> OR IF WORK IS SUSPENDED FOR, 1 $0 DAYS, <br /> <br /> 2A. CONTIL4.CTOR ~NSTALLATION ONLY <br /> <br /> !o,m''- <br />] Mailing Add.ss <br /> <br />FOR OWNER INSTALLATIONS <br /> <br />Owneds Signature <br /> <br />3. PLAN REVIEW SECTION <br /> <br />IL~$IDBNTIAL [~ COMMERCIAL <br /> <br />NEW [~ ALTERATION ~ ADDITION ['] RELOCATION <br />BASE FE]Z <br /> <br />$I0,00 <br /> <br />l%mcd Air Fun~c¢ $ 6,00 <br /> 100,000 BTU or less -- <br /> Over 100,000 BTU .,, $%$0 <br /> <br />Floor Furnace .,, $ 6,00 <br />Sust~aded Heater __ $ 6,00 .. <br />Wall Heater __ $ 6,00 <br />Floor Mounted Unit Heater ~ $ 6,00 <br />Heat Pump [] / Air Conditioner [] <br />Up to ~ Ton $ 6.00 <br />5; Ton to 15 Tea $! 1.00 <br />Evaporative Cooler $ 4,30 <br />Exhaust System, Commerc, ial $ 4.50 <br />Hood attd Exhaust. Comm. emial ..... $ 4,$0 <br /> <br />Domestic Range Hood ~ $ 4.50 <br />Domestic Exhaust Fans <br />and Dryer Vents __ $ 3,00 <br />Fire Damper ____ $ <br />Wood Slove --L- $ 7.50 <br />Furnace Ducts (Alteration, Extension) ~, $4,$0 <br /> <br />Com~lercial or Industrial IncLuerator __ $30,00 <br /> <br />Oas Water Heater (relocaQon <br />or replacement) .,, $ 7.50 <br />Gas Connection <br />--per outlet, up to 4 ., $ ZOO <br /> --over 4, SS.00 plus. ea, <br /> additional __ $ <br /> <br />FOr the L~stallation, Relocation <br /> or Replacement of es. Appliance <br /> V'eat not included in an <br /> Appliance pmxuit. <br /> <br />$ 3.00 <br /> <br />Other (as required by Building Official) <br /> <br />We will provide plan review service if you complete Sectiort <br />5B and submit two (2) sets of plans and specifications with <br />tl~is application. <br /> <br />This optional phm review program does not suspend the <br />required submission of plans and specifications when required <br />by {he Oregon Structural Specialty Code, Chapter 53. <br /> <br />$. FEES <br /> <br />$ <br />s <br /> <br /> <br />