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~FOR OFFICE USE ONLY1 <br />Received by: <br /> Date: <br /> <br />MECHANICAL PERMIT APPLICATION <br />Please complete all Sections, I through 5 <br /> <br /> l, LOCATION OF INSTALLATION <br /> <br />&badd~s~ ~qe~ /~ /I <br /> <br />Cross St, <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> <br /> 220 High Street NE <br /> Salem, Oregon 97301 <br /> <br /> Phone 588-5147 $:00 a_m, ~ 4:30 <br /> Code-A-Phone: 588.7904 <br /> FAX; 55S-7948 <br /> <br />SITE #: <br /> <br />Date: <br /> <br />Issued by: <br /> <br />Porm~ No. <br /> <br />RESIDENTIAL"~ COMMERCIAL <br /> <br />USE OF S~/RUCTUI~: <br /> <br /> s~wD ~Tm~nos'lSk.~mos [] ~r~mca~os [] <br />Directions NO, X ~:~;~; = SvM <br /> <br />I PERM1TS ARE NON-TP,~,NSFERABLE AND NON-REFUNDABL~ AND <br /> <br /> 2A, CONTILa, CTOR INSTAI,LATION ONLY <br /> <br />25. FOR OWNER INSTALLATIONS <br />['rope[fy Owncr <br />Mailtag Address Fhone <br />City/Stat~dZip <br /> <br />Tile installation is being made on property I own which is not intended for sale. <br />lease~ or rent. <br /> <br />Fomed Air Furanee [ $ COO <br />100,000 BTU or less <br />Over 100,000 BTU -- $ 7,50 <br /> <br />Floor Fttma~o __ $ <br />Suspended Hcat¢~ $ 6.00 <br />Wall Heater __ $ 6.00 <br />Floor Mounted Unit Heater __ $ 6.00 <br /> <br />$I0.00 <br /> <br />Heat Pump or Air Conditioner <br />Upto 3 Ton ] $6.00 <br />3 Ton to 15 Ton $11,00 <br />Evaporative Cooler __ $ 4.50 <br />Exlmust System, Commercial __ $ 4,50 <br />Hood and Exhaust, Commercial __ $ 4,50 <br /> <br />Domestic Range Hood __ $ 4.50 <br />Domesti¢ Exhaust Fans <br />and Dryer Vents __ $ 3.00 <br />Fire Daml~r __ $ 3,00 <br />Wood Stove __ $ 7.50 <br />Furnace Ducts (Alteration, Extension) __ $ 7.50 <br /> <br />Commercial or Indus~al Incinerator __ $30.00 <br /> <br />Gas Water l-Icater (relocatioa <br />erreplacemant) __ $ 7.50 <br />Gas Com~¢ction <br />.- o tt t,u to4 $:.00 <br />--over 4, $$.00 plus ea. <br />additional $ .50 <br /> <br />For the Installation, Relocation <br /> or Relalaoem~t of ea. Appliance <br /> Vent not included in an <br /> Appliance permit, <br /> <br />__ $ 3.00 <br /> <br />['LAN REVIEW SECTION <br /> <br />Other (~s i~luired by Building Official) <br /> <br />We will provide plan review service if you complete Section <br />55 ~nd 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 />lC 1J.4J <br />Rev. 10/92 <br /> <br /> <br />