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FOR OF~FICE USE ONLYI <br />Received by: <br /> <br /> Phone 558-5147 s:oo~m.-4:30 p,m, <br /> Code-A-Phone:555-7904 <br />MECHANICAL PERMIT APPLICATION <br />P/ease complete all Sections, 1 through 5 <br /> <br />220m $ et 0CT - 199 <br />Salem, Oregon 97301 <br /> MARION COUNTF, r~ No <br /> ~DINu iNSPECTION <br /> Dme: <br /> <br />Issued by: <br /> <br />1. LOCATION OF iNSTALLATION <br /> <br />PEPdVIITS APE NON-TRANSFERABL/~ AND NON-REFUNDABLE AND <br />EXPIRE IF WORK IS NOT STARTED WITHIN 1 SO DAYS OF ISSUANCF, <br />OK IF WO P,I~_ IS SURPEND]~D FOI~. 1 $0 DAYS- <br /> <br />2A, CONTRACTOR INSTALLATION ONLY <br /> <br />Contracwf s Board Reg. No. ~ ~,~ q [lob No. <br /> <br />ZB, FOR OWNER INSTALLATIONS <br /> <br />Peope~y Owner <br />Mailing Address Phone <br />City/State/Zip <br /> <br />Owncds Signature <br /> <br /> 3. PLAN REVIEW SECTION <br /> <br />RESIDENTIAL j]~ COMMERCIAL <br /> <br />Fo~ed Air Furnace ] $ 6.00 <br />100,000 BTU or less <br />Over I00,000 BTU $ 7.50 <br /> <br />Floor Furnace __ $ 6.00 <br />Suapended Heater __ $ 6,00 <br />Wall Healer $ 6.00 <br />lqoor Mounted Unit l-I~ater __ $ 6.00 <br /> <br />Heat Pump or Air Conditioner <br /> Up to 3 Ton <br /> 3 Tnnto 15 Ton <br />Evaporative Cooler <br />Exhatmt Systen% Commercial <br />Hood and Dthaust, Commercial <br /> <br />Domestic Range Hood <br />Domestic Exhaust Fans <br />and Dryer Vents <br />Fire Daml~r <br />Wood Stove <br />Furnace Ducts (Air.alien, Extension) __ <br /> <br />Commercial or Induslrlal Incinerator <br /> <br />Gas Water Heater (relocation <br /> er replacement) <br />Gas Connection <br /> --per outlet, up to 4 <br /> ~-over 4, Sg,00 pltl$ ea. <br /> additional <br /> <br />For the Installation, Relocation <br /> or Replacement of cu. Appliance <br /> Vent not/ncluded in ~ <br /> Appli~ce ~it, <br /> <br />Other (as required by Building Official) <br /> <br />6.00 <br />$11.00 <br />4.50 <br />$4.5o <br />4.50 <br /> <br />__ $ 4,50 <br /> <br /> $ 3,00 <br />__ $ 3,00 <br />-- $ 7,50 <br /> $ 7.50 <br /> <br />__ $30,00 <br /> <br />7.50 <br />2.00 <br />,50 <br /> <br />__ $ 3.00 <br /> <br />We will provide plan review 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 Struetaral Specialty Code, Chapter 53. <br /> <br />~fC"Y ~-41 <br /> <br />Rev, lO/92 <br /> <br />$ <br />$ __ <br /> <br />$10.00 <br /> <br /> <br />