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FOR CITY VALIDATION <br />Received by: <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> COMMUNITY DEVELOPMENT CENTER <br /> 285 Church St NE · P, oom 132 PERMIT NO: <br /> Salem, OR 97301 <br /> <br />24 Hr lnapection Line: 588--7904 <br />Office: 588-5147 8:00a.m.-4:30p.m. <br />FAX; 588-7948 <br /> <br /> MECHANICAL PERMIT.APPLiCATION <br /> Please complete ~11 Sections, I through ~ <br /> <br />1. LOCATION OF INSTALLATION <br /> <br />PF. RMITS ARE NON-TRANSFERABLE AND F,,X H P~ IF WORK IS NOT <br /> STARTED WITHIN 180 DAYS OF <br /> woRK IS SUSPENDED FOR lg0 DAYS. <br /> <br />2A. CONTRACTOR I~STALLATION ONLY <br /> <br />Contractor's Board R~g, No, ] Job No, <br /> <br />3. PLAN REVIEW SECTION <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 plato and <br />spec ficat onsw th th s application. <br /> <br />Mt7 I,q~ I <br />Rt..~ 12~I <br /> <br />Dato: <br /> <br />Iaauocl by: <br /> <br />4. FEE SCHEDULE (Complete and enter total in Al below) <br /> <br /> RESIDENTIAL I~1 COMMERCIAL ~l <br /> USE OF STRUCTURE: <br /> NEW rn ALTERATION r~ ADDITION 12 RELOCATION <br /> GAS LI or ELECTRIC CI <br /> Nc, X P~o = Sum <br />BASE FEE $1o.oo <br /> <br />FORCED AIR FURNACE <br />up to 100,000 BTU $ 6.00 __ <br />over 100,000 BTU $ 7.00 __ <br /> <br />Floor Furnace $ 6.00 <br />Suspended Heater $ 6,00 __ <br />Wall Heater $ 6.00 <br />lqoor Mounted Heater $ 6.00 <br /> <br />HEAT PUMP <br />under 3 Too $ 6.50 <br />3 Ton and up $11.00 __ <br /> <br />AIR CONDITIONER <br />un&r 3 Ton $ 6.50 <br />3 Ton and up $11.00 __ <br /> <br />EvaporativeCooter $ 4.50 <br />Commercial Exhaust System $ 4.50 <br />Com~ncrcial Hood ami Bxhaust $ 4,50 <br />Domestic Range Hood $ 4,50 <br /> <br /> and Drycr Vents $ 3.00 __ <br /> <br />Wood atovrdFimplace t~ $ 7.30 <br />Furnn¢¢ Duets (Ail exat ion/Ext en alorl) $ 7,50 <br />Commercial / Industrial Incinerator <br /> <br />ADDITIONAL APPLIANCEe <br /> <br /> Gas Log Lighter $ 7.50 <br /> Gas Barbcqu~ $ 7,50 <br /> Other $ 7,50 <br /> <br />OAS PIPING <br />14 outleta (petoutlel) $ 2.00 <br />4 aad up oull~l~ (pgr outlet) $ .50 <br /> <br />Appliance. Venla not included in <br />an appllanee pemllt $ 3,00 <br /> <br />OTHER Os requi£od by Builo~ng <br /> <br />DWELLING PERMIT LAIIEL # of Labels N/C <br /> <br />5, FEES <br />A 1. l~ltet tolol of fees from Sec. fi4 $ <br />A2, Add 5% sumharg~ (,05 x Al) $___ <br />Subtotal <br /> <br /> B. Enter 25% of lineAl fotPlan R~view <br /> (Al + .25), if r~quiz~d $__ <br /> C, Investigation F¢¢ (if required) $ <br /> D. Reimpcction Fee ($25.00) $ <br /> <br /> TOTAL AMOUNT DUE <br /> Receipt No. <br /> <br /> <br />