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FOR CITY VALIDATION <br />Received by: <br />Date: <br /> <br />MECHANICAL PERMIT.APPLICATION <br />Please complete all ,~ections, I through $ <br /> <br />MARION COUNTY BUILDING INSPECTIO~'~.xv-~/.~~ <br /> COMMUNITY DEVELOPMENT CENTER <br /> 285 Church St NE · Room 132 ~ <br /> Salem, OR 97301 Oat~~ <br /> 24 Hr ln~c~ction Lin~ 58~-7904 <br /> on-,~ 5~-st4'/8:0O*.m.-4:30p.,-. ~ssuod by:MARION <br /> <br />1. LOCATION OF INSTALLATION <br /> <br />· / <br /> <br />PERMITS ARE NON-TRANSFERABLE AND EXPIRE IF WORK IS NOT <br /> STARTED WITH1N 1~0 DAYS OF ISSUANCE OR IF <br /> WORK IS SUSPEHDED FOR 180 DAYS. <br /> <br />4. FEE SCHEDULE (Complete and enter ;otni in Al below) <br /> <br />2B. FOR OWNRR IN~'rALLATIONS <br /> <br />Property Owner (please pri~) <br /> <br />Mailing Addre~ ~e <br /> <br />city/s~p <br /> <br />~'s Si~: <br /> <br />A~nt's Si~: <br /> <br />3. PL~ ~EW S~TION <br /> <br />B/tilE FEE <br /> <br /> RESIDENTIAL ~ COMMERCIAL O <br />USE OF STRUCTURE: <br />NEW O ALTERATION O ADDITION ~4~LOCATION O <br />GAS C] or ELECTRIC ~! <br /> No. X F~ .~ Sum <br /> $1o.0o <br /> <br />FORCED AIR FURNACE <br />upto 100,000 BTU $ 6.00 <br />over 100,000 BTU $ 7.00 <br />~or Furnace $ 6.00 <br />Sunpeoded Heater $ 6.00 <br />Wall Heater $ 6.00 <br />Floor Mounted Heater $ 6.00 <br /> <br />HBAT PUMP <br />~d~3 To. / $ 6.~ ~,~'o <br />3 Ton and up $11.00 ~ <br /> <br /> AIR CoI~mONER <br /> under 3 Ton $ <br /> 3 Ton and up $11.00 <br /> <br />EvaporativeCooler $ 4.50 <br />Commercial Exhaust System $ 4,50 <br />.~..~.'.ml. ,H. ~o~.,. and Exhaust $ 4.50 <br />::~~~ i:~: ,7~ ~:.~,~' ::~:'~~. ?~:.~,:~' $ 4.~0 <br /> <br /> FLr~ Damper $ 3.00 <br /> Wood Siove/Firepiace $ 7.50 <br /> Furnace Ducts (ARerafiou/Extmsion) $ '/.50 <br /> <br />ADDITIONAL APPLIANCe8 <br />Ohs Water Heater $ 7.50 <br />Gna Log Lighter $ 7.50 <br />Gna Barbeque $ 7.50 <br />O~r $7.50 <br /> <br />OAS PIPING 8Y~TBM <br />1-4 outlctn (per outleO $ 2.00 <br />4 and up outleta (per outlet) $ .50 <br /> <br />Appliance Vents not included in <br />an appliance permit $ 3.00 ~ <br /> <br />OTHER (~s required by B~l&~g <br />DWELLINO I~RMIT LABEL <br /> <br />NIC <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. 1~4 <br /> <br />5. FEES <br /> Al. F. mer total of fec~ from Sec. ~4 <br /> A2. Add 5% sm'charge (.05 x Al) <br /> ~bt~l <br /> <br /> B. ~ter 25~ of l~e Al for P~ Re~ew <br /> (Al + ~5), ~d <br /> C. ~v~gation ~e (if~qu~) <br /> D. Rc~c~n ~ (~.~) <br /> <br /> TOT~ ~O~ D~ <br /> R~eipl No. <br /> <br />$.~ <br />$ <br />$ <br /> <br /> <br />