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FOR CITY VALIDATION <br />Received by: <br />Date: <br /> <br />24 Hr Inspection Line: 588-'/ 04 ' <br /> <br />IMECHANICAL PERMff APPLICATION <br />Please complete all ,~ections, I through 5 <br /> <br />1. LOCATION OF INSTALLATION <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 180 DAYS. <br /> <br />2A. COHTRACTOR INSTALLATION ONLY <br /> I <br /> <br />Conlractor's License No. <br /> l,o, / <br /> <br />2B. FOR OWNER INSTALLATIONS <br /> <br />Property Owner (plesse prim) <br /> <br />Mailing Address J Phone <br /> <br />City/State/Zip <br /> <br />Owner's Signature: <br /> <br />Agent's Signature: <br /> <br />4. FEE SCHEDULE (Complete and emer total in A! below) <br /> REBIDENTIAL ~ COMMERCIAL [~ <br /> USE OF ~TRUCT~. <br /> NEW Cl ALTERATION.~ ADDITION El RELOCATION <br /> GAS O or ELECTRIC.~ <br /> ! - No. X Fee -. 8om <br /> <br /> BASE FEE $10~00 <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 Healer $ 6.00 <br /> Floor Mounted Heater $ 6.00 <br /> <br />HEAT PUMP <br />under 3 Ton $ 6.50 <br />3Ton and up $11.00 ,. <br /> <br />AIR CONDITIONER <br />under 3 Ton ~ $ 6.50 <br />3 Ton and up $1 !.00 <br /> <br />EvaporstiveCooler $ 4.50 <br />Commercial Exhaus~ System $ 4.50 <br />Commercial Hood and Exhamt $ 4.50 <br />Domestic Range Hood $ 4.50 <br />Domestic Exhaust Fans <br />and Dy/er Veins $ 3.00 <br />F'~e Damper $ 3.00 <br />Wood S~ove/Fircplace $ 7.50 <br />Furnace Ducts (Alterstion/Extension) $ 7.50 <br />Commercial / Industrial Incinerator $30.00 <br /> <br />ADDITIONAL APPLIANCE8 <br />Oas Water Healer $ 7.50 <br />Oas Log Lighter $ 7.50 <br />Oas Bad.quo $ 7.50 <br />Othcr $ 7.50 <br /> <br />GA8 PIPINO SYSTEM <br />1-4 outlels (per outlet) $ 2.00 ~ <br />4 and up unflels (per outlet) $ .50 ~ <br /> <br />Appliance Venl~ not included in <br />an appliance permit $ 3.00 .... <br /> <br />OTHER (ss required by Buil~'~ O~ci~l) <br /> <br />DWELLINO PERMIT LABEL # of Labels N/C <br /> <br />3. PLANRHVlEW 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 plans and <br />specifications with this application. <br /> <br />MC 15-41 <br />Rev. 12/94 <br /> <br />5. FEES <br /> A 1. Enter Iolal of feea froln <br /> A2. A~ 5% s~h~ (.05 x Al) <br /> ~bl~i <br /> <br /> B. ~ter 25~ of I~e A i for P~ Renew <br /> (A I + ~5), if ~ $.~ <br /> C. ~nv~tipt~n ~ (if~qui~) $.~ <br /> D. Reim~ct~n ~e (~S.~) $.~ <br /> <br /> TOT~ ~O~ D~ <br /> Rcccipl No. <br /> <br /> <br />