Laserfiche WebLink
FOR CITY VALIDATION] <br />Received by: <br />Date: <br /> <br />MARION COUNTY BUILDING INSPI~CTION <br />COMMUNITy DEVELOPMENT CENTER <br />285 Church St NE · Room 132 <br /> Salem, OR 97301 <br /> <br />IMECHANICAL PERMIT APPLICATION <br />Please complete all Sections, I through 5 <br /> <br />22, Hr Inqpectlon Line: 588-7904 <br />FAX: 588-7948 <br /> <br />pERMITS ARI~ NON-TRANSFERABI~ AND I~XpIRE IF WORK IS N~ ] <br /> STAR~ ~IN 1~ DAYS OF ISSUANCE OR IF <br /> I <br /> WO~ IS SUSP~D~ FO~ 180 DAYS. <br /> <br />2~,, CONTRACTOR INSTALLATION ONLY <br /> <br />_co,'a,-.~,.?~2.,So.,,a R~...N~..'"' .. ,.. . Job n?~.:.. ~ <br /> <br />211. FOR OWNttR I~8TALLATION,q <br /> <br />l%opeay Own,r (ple~oprint) <br /> <br />PERMIT NO: <br /> <br />Date: <br /> <br />Issued by: <br /> <br /> 4. FEE SCHl~.D~ (Complete and enter total in Al below/ <br /> \/ <br /> RESIDENTIAL ~1 . COMMERCIAL~ <br /> <br /> NEW.~ ALTERATIOIq, J~,~.ADDITION O RELOCATION <br /> GA$~ or ELECTRIC CI <br /> /~ No, X Fe~ = Sum <br /> ~ASE FEE $10.00 <br />~FO~CED AIR FURN~ACE ~ <br /> upto 100,000 ETU _~X. $ 6.00 <br /> <br /> over 100,000 BTU $ 7.00 <br /> <br />Floor Furnace $ 6,00 <br />Sual~ndcd Heater $ 6.00 <br />Wall Heater $ <br />Floor Mounted H~ater $ &fro <br /> <br />HEAT pD'MP <br />under 3 Ton .... $ 6.2;0 <br />3 Ton and up .... $11.00 <br /> <br />AIR CONDITIONER <br />tender 3 TOn ~.f~-%~ $ 6.50 <br />3 Ton and Up <br /> <br />EvaporativeC~lgr $ 4,50 <br />~mmereiM E~aust $yslem <br />Commegial H~d all~ E~aust $ 4.50 <br /> <br />all appliano(~ permit $ 3.00 <br /> <br />OTHER Os mqoired by Builddqg Ol~ctM) <br /> <br />DWELLING PERMIT LABIAL # of Labala <br /> <br />5. FEllS <br /> <br /> 3. PLANRt/VIBW SBCTION <br />/Mitten Co-Ely oes not';eq.i e a lan r, view, <br /> We will provide plan review service if you ,complete <br /> Section 5B aEd submit two (2) sets of plans and <br /> specifications with this application,, <br />MC l.q,41 <br />Rev, <br /> <br />A I. Enter total of l~es from See. #4 <br />Ag, Add 5% sureh:~g¢ (.05 x A 1) <br /> <br />Subtotal <br /> <br />B. Emer 25% Gl' line A 1 for Plan Review <br /> (A 1 + .25). if required <br />C, Investigation Fee (if requital) <br />D, E¢imp¢~tion Fee ($25.00) <br /> <br />TOTAL AMOUNT DUE <br /> <br /> <br />