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FOR CITY VALIDATION <br />Received by: <br />Date: <br /> <br />MARION' COUNTY BUILDING INSPI~CTION~ <br /> COMMUN~Y DEVELOPMENT CENTER <br /> 285 Church St NE' Room [32 <br /> <br /> I <br />MECHANICAL PERMiT APPLICATION [ <br />Please complete ail ~ections, 1 through 5 <br /> I <br /> <br /> Salem, OR 97301 <br /> <br /> 24 Hr Insp~tion Lisa: 588-7504 <br />Ofl'm~: $88-51,~7 $:0Oa.m.-4:30p.m. <br />FAX: 5a8-7948 <br /> <br /> 1, LOCATION OF IlqSTALLATION <br /> <br />.~?t2'.~75~29.')~ ......................... <br /> <br />PERMITS ARE NON.TRANSFERABLE AND EXPIRE IF WORK IS NOT <br /> STARTED WITHIN 180 DAYS OF ISSUANCE OR IF <br /> WORK IS SUSPENDED FOR lB0 DAYS. <br /> <br />2A. CONTRACTOR INSTALLATION ONLY <br />I J ....... <br /> <br />2B. FOR OWNIIR INSTALLATIONS <br /> <br />..,,,,.,.^..... ................... :2: <br /> <br />Owner's Signature , <br /> <br /> 3. PLAN REVIEW SECTION ' <br />lMarion County does not require a. plan review. J <br />We will provide plan review sezme if you completq, <br />Section 5B and subm!t two (2) sets of plans and <br /> specifications with th~s app.}!yation.. <br /> <br />MC 1,5-41 <br /> <br />Date: <br /> <br />4. FEE SCHEDULE (Complete and enter fatal in Al below) <br /> <br /> RESIDEiWI'IAL J~ COMMERCI~ ~ <br /> US~ O~ ~RUCT~E: <br /> NEW~ ALTERATION O ADDfflON O R~OCATiON O <br /> GAS~ or ELECTRIC 0 <br />B~E FEE $10,~ <br /> <br />FORCED AIR PURNAC£ <br />up lis 100,000 BTU $ 6.00 <br />over I(X),(Y-Yd BTU $ 7.00 <br /> <br />lqoor Fumacc $ 6.00 <br />Suspended Heater $ §,00 __ <br />WMI Heater $ 6,00 <br />Floor Mounted Heater $ 6,00 <br /> <br />HEAT pDMP <br />under 3 Ton $ <br />3 Ton and up $ [ 1,00 <br /> <br />AIR CONDITIONER <br />trader 3 Ton $ 6.50 <br />3 Ton and up $11,00 <br /> <br />Evap~raliveCooler $ 4..50 <br />C, ommcrcJal Exhaust Syst¢ltl $ 4,~0 <br />Comm~rclnl Hood and Exhaust $ 4.50 <br /> <br />woo. StoveFi~ola~ 7 $ 7,50 <br /> <br />ADDITIONAL APPLIANCES <br />Gas Water Heater $ 7.50 <br />Gas Ix~s Lighter $ 7,30 <br /> <br />DWELLIHO PERMIT LABEL #of Labels <br /> <br />5. FEES <br /> <br /> <br />