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FOR OFFICE USE ONLY <br />Received by: ,. <br />Date: ,, <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> <br />COMMUNITY DEVELOPMt~NT CENTEP. <br />285 Church St. NE - P. oom 132 <br /> Salem, Or¢son 97301 <br /> <br />MECHANICAL PERMIT APPLICATION <br />Please comp/ete all Sections, I through 5 <br /> <br />Phone 5SS-514'/ $:~ a.m. - 4:30 p.m. <br />Code-A-Phone: 588-7904 <br /> FAX: 58S-7948 <br /> <br />SITE #: <br /> <br />Date; <br /> <br />ISsued by: <br /> <br />MARION COUNTY <br />BUILDING INSPECTION <br /> <br />PERMITS ARE NON.TRANSFI~RABLE AND NON.REFUNDABLE AND <br />.EXPIRE IF WORK Is NOT STARTED WITHIN 180 DAYS OF ISSUANC]~ <br /> <br />OR IF WORK IS SUSPENDED FOP. 180 DAYS. <br /> <br /> 2A. CONTRACTOR iNSTALLATiON ONLY <br /> <br />Mailing <br /> <br />Contractors Li¢*n~ No. <br /> <br />Coatr~ctoCs Board R.¢S. No. <br /> <br />Contractors Signature: <br /> <br />2B, FOR OWI~ER INSTALLATIONS <br /> <br />3. PLAN REVIEW S~CTION <br /> <br /> USE OF S'IRU~: <br /> <br /> NEW [] ALTERATION ~ ADDITION ~ RELOCATION <br /> <br />I~.SE FEE <br /> <br />= SUM <br /> $~0.00 <br /> <br />Forced Air Furnace $ 6.00 <br />lO0,O00 BTU or less <br />Over 100,000 BTU -- $ 730 <br /> <br />Floor F~rnace __ $ 6.00 <br />Su~p~ded Heater __ $ 6.00 <br />Wall H~ater $ 6,00 <br />Floor Mounted Unit l-I~ater $ 6,00 <br /> <br />Heat Pump [] / Air Conditioner [] <br />Up to3Ton -- $6.00 <br />3 Ton to 15 Ton $11,00 <br />Evaporative Cooler $ 4,$0 <br />Exhaust Sys~an, Commercial __ $ ~.50 <br />Hood and Exllaust, Commercial __ $ 4,$0 <br /> <br />Domestic P,a~ge Hood ... $ 4.50 <br />Domes~¢ Exhaust <br />and Dryer Vents ~ $ 3,00 <br />Fire Damper __ $3,00 <br />Wood Stove $ 7.50 <br /> <br />Commercial or [ndush-ial ]'ncincrator __ $30,00 <br /> <br />Gas Water He~r (ralecal~on <br />or replacemmt) $ 730 <br />Gas Connection. ,. <br />-per outteL -ap to ~ ~_ $ <br />--over 4, $8,00 plus en, <br />additional $ ,50 <br /> <br />For the Inztallation, Kelocation <br />er Rcplaceraent o£ea, Applia~c¢ <br />Vent not included in an <br />Appliaaccpermit. __ $ 3,00 <br /> <br />Other (as required by Building Official) <br /> <br />We will provide plan ~eview service if you complete 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 />required submission of plans, and specifications when required <br />by the Oregon Structural Specialty Code, Chapter <br /> <br />MC' /5-4/ <br />Rev, 8194 <br /> <br />s 1%-7-0 <br /> <br /> <br />