Laserfiche WebLink
MAI~I.. ON~.~_ O,U~ITY BUILDING INSPECTION <br /> <br /> 8'llld~lL~ U~ u -'28SChhrehSt NE' t-.~)m ~z ' · <br />FOR CITY VALiD;~ [ , -- ~l~TSalem. OR 97301 _ <br /> <br />Dat~: · ~ ' ~ Hr Insp~t~n Liner 58~7~ <br /> F~: 588-79~8 <br /> <br />MECHANICAL <br />P/ease complete ~1 ~tions, 1 through 5 <br /> <br />1. LOCATION OF iNSTALLATION <br /> <br />IPF..RMIT$ ARE NON-TRANSFERABL~ AND EXPIRE IS NOT <br /> WORK <br /> STARTED WITl-IIN 1~ DAY~ OF ISS~dANC~ OK IF <br /> wo,K :s susPmDm PO, l~ ~.^:s. <br /> 2t, CO~tCTO~ m~:t~:ON dray <br /> <br /> ~ntraeot ',J [ i')OD% ~kJ Phone ~-~ <br /> <br /> 2B. FOR OWlql~R INSTALLATIONS <br /> <br /> Pto~.rly Owner ~1~ prinO <br />....,, 2L <br /> <br />3. PLAN REVIEW SECTION <br /> <br /> 4- FEE ~C~ED~ (C(~upl~{~ ~nd eatet total in At b~low) <br /> RESIDENTIAL ~/ ~OMMERCiAL ~l <br /> NEW ~ ALTERATION ~ ADDiTiON ~ R~ATION ~ <br /> GAS ~ or ~EC~IC ~ ~ <br /> <br />~FSR~b AIR FURNACE <br />up m 100,~0 g~ -- S 6,00 ........ <br />over n~,iDo B~ -~ $ 7.00 <br /> <br /> Sua~nded Healer $ 6,~ ........ <br /> Wall Heater ..... $ 6.~ ~ <br /> Floor Mounled Healer $ 6,~ ..... <br /> <br />IIEAT PUMP <br />under 3 Ton $ 6.50 <br />3 Ton arid up $ t t .00 <br /> <br />^~z co~mT~Otq~* <br />,,,o~ ~ To,, I ,6.~o <br />3 Ton ~nd up $11,00 <br /> <br />Evaporativ~Ier $ 4.50 <br />C~me~ia[ ~a~St $~s~m $ 4.50 <br />Commemial Hood and E~au~t . $ 4.50 <br />~m~sti~ R~ge HO~ $ 4,50 <br /> <br />~d D~c* Vents $ 3.00 <br />Fire Damper $ 3.~ <br />Wood Smve~ireplaco $ 7,50 <br /> <br />Marion County does not require a plan review. <br />We will provide plan review service if yOu complete <br />Section 5B and submit two (2) sets of plans and <br />specifications with this appllcation. <br /> <br />tic 15,41 <br /> <br />FEES <br />Al. Enlcr ti)iai Of I~3S i~01t~ Sec, #4 <br />A2, Add 5% ,urchargo (.05 x A 1) <br /> <br />Subtotnl <br /> <br />B, Enter 25% of line Al f0r Plan Review <br />(A 1 * .25), if required $, __ <br />~. lnv~atigatioll p0cj (if ~quPmd) <br />D, Rclmpeetion F*~o ($25,00) $.__ <br /> TOTAL AMOUNT DUE $,,17" ~-~ <br />Receipt No, <br /> <br /> <br />