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FOR OFFICE USE ONLY <br />Received by: <br />Date: <br /> <br />MECHANICAL PERMIT APPLICATION <br />Please complete all Sections, 1 through 5 <br /> <br /> 1- LOCATION OF INSTALLATION <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> <br /> Salem, Oregon 97301 <br /> <br /> Phoa¢ ~8-5147 8,'00 a,m, - 4:30 p,al. Slq~E, ~;1 Porffil <br /> Code. A-Phoae: 588-7904 <br /> v x: ssa-7 4a COUNTY <br /> BUILDING iNSPECTION <br /> ISSued by: <br /> <br />PERMITS ARE NON.TRANSFERABLE AND NON-REFUNDABLE AND <br />EXPIRE IF WORK IS NOT STARTED WITHIN 150 DAYS OF ISSUANC~ <br />OI~IF WORK IS SUSPElqDED FOlk 180 DAys, <br /> <br />2A. CONTRACTOR INSTALLATION ONLY <br /> <br />¢oatra~tot's Li~ea~ No, <br /> <br />2B, FOR OWNER INSTALLATIONS <br /> <br />CJ~y/State/Zjp <br /> <br />Th~ in$~llation i~ being mad~ on propc~y I o~ which is not in~dcd for <br /> <br />O~s Sign~ <br /> <br /> 3, PIAN ~V]~W <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 pro,cam does not suspend the <br />required submission of plans, and specifications when required <br />by the Oregon Structural Specialty Code, Chapter 53. <br /> <br />Rev, 3/93 <br /> <br />RESIDENTIAL ~) COlvll~ <br /> <br /> USE OF 5TRUCTUI~; <br /> NEW [] ALTERATION~ADDITION [] RELOC, q ~ <br /> GAS~ or ~LECTRIC~ <br /> B~ ~ $10.00 <br /> <br /> Ferc~d ~ F~e ~ 6.00 ~,O0 <br /> 100,000 B~ or I~ <br /> ~ I00,000 ~ 7.50 <br /> <br />~oor F~ce ~ 6.00 <br />S~dcd H~at~ ~ 6,00 <br />W~I Heat~ 6.00 <br />~oor Mo~ted U~t ~t~ 6,00 <br /> <br />Heat Pump ~ / Air Condi~on~ ~ <br />U~to 3 To~ ~ 6.0o G.oo <br />3 Torito 15 To~ 11.00 <br />Ev~po~tiw Cool~ 4.50 <br />~t Syst~, C~m~ 4,50 <br />~ood ~ ~, Co~i~l 4,50 <br /> <br />Domestic ~ Hood 4.50 <br />Domestic ~a~t F~ <br />~d ~ V~ts 3,00 <br />F~ D~ ~ 3,00 <br />Wood Stove ?.50 <br />~e ~ (~t~atin~, Ext~an) ~.50 <br /> <br />Co~cial or ~d~ ~at~ ~0-00 <br /> <br /> or ~lac~t) / 7,50 ~ 50 <br /> --~ outi~t, Bp to 4 ~ 2.00 q, OO <br /> additi~ ,50 <br /> <br />For the Installation, Relocation <br /> or Replaceraent of ca. Appliance <br /> V~at not included ia ma <br /> Appliance per.it. <br /> <br />Other (as required by Building Official) <br /> <br />3.00 <br /> <br /> <br />