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FOR CITY ~ ~AL. I ~DA~ION ] <br /> "' I <br /> <br />MECHANICAL PERMIT APPLICATION <br />Please complete all Sections, I through $ <br /> <br />L LOCATION OF INSTALLATION <br />~obAddre~ ¢~ff ~"~, ~1 <br /> <br />COMMUNITY DEVELOPMENT CENTER p~RMrrllil~ .f~ <br /> 285 Church St NE' Room 132 ~..~' <br /> Salem, OR 97301 <br /> Date: <br /> <br /> 24 Hr Inspection Line~ 588-7904 <br /> om== 5ss-st4? s=ooa.m.-4=30p.=. Issued by: _!lUll_DIN6 INSPECTION <br /> FAX: 588-7948 <br /> <br /> 4. Fl~ SCIIBDULE (~omplo~.d ~ to,al in Al below) <br /> --/ <br /> RESIDEHTIAL ~ COMMERCIAL <br /> <br /> NEW ~ALTERAT[ON ~i~DD1TION <br /> GAS ~ or ELECTRIC [] <br /> No. X Fee = Sum <br /> BASE FEE $10.00 <br /> <br />I PERMITS ARE NON-TRANSFERABLE AND EXPIRE IF WORK IS NOT <br /> STARwoT~D~ isW~ U%]p~A~SF~%I~ ~UDA% SCE. OR IF <br /> <br /> 2A. ColgrRACTOR INSTALLATION ONLY <br /> <br />Mailing Address <br /> <br />Contractor's License No, <br /> <br />Job No. <br /> <br />Co~tractor's Ih>aid Res, No, <br /> <br />2B. FOR OWNER INSTALLATIONS <br /> <br />FORCltD AIR FURNACE <br />up to 100,000 BTU $ 6.00 <br />over lO0,000 BTU $ 7.00 <br /> <br />Nicer Furnace $ 6.00 <br />Suspended Heater $ 6.00 <br />W, ll H.tex ~ $ 6.00 <br />Floor Mounted Heater $ 6.00 <br /> <br />HEAT PUMP <br /> under 3 Ton <br /> 3 Ton and up <br /> <br />AIR COI~HTIOI~R <br /> under 3 Ton <br /> 3 Ton aad up <br /> <br />EvnperativeCooler <br />Commercial Exhaust System <br />Commercial Hood and Exhaust <br />Domestic Range Hood <br />Domestic Exhaust Nam <br /> and Dryer Vents <br />Fire Damper <br />Wood Stove/Fireplace <br />Furnace Duc~s iAltezatlo~=.xt emion) <br />Commercial ! Indus,'iai Incinerator <br /> <br />Gas Log Lighter <br /> <br />$ 6.50 <br />$ll.00 -- <br /> <br />$ 6.50 -- <br />$11.00 -- <br /> <br />$4.50 <br />$ 4.50 __ <br />$ 4.50 <br />$4.50 <br /> <br />$ 3,00 <br />$ 3.00 <br />$7.50 -- <br />$7.50 <br />$3o.oo <br /> <br />$7.~0 -- <br />$ 7.50 <br />$73O -- <br />$7.50 -- <br /> <br />GAS PIPING SYSTEIVl <br /> 1-4 outlet~ (per ou0et) <br /> 4 and up oufle~ (per outlet) <br /> <br />Appliance Vents not included in <br />an appliance permit <br /> <br />OTHER (es required by Building Ol~ciM) <br /> <br />DWELLING PERMIT LABEL # of Labels <br /> <br />$ .50 __ <br /> <br />$ 3.00 -- <br /> <br />5. FEBS <br /> A I. Enter totel of f~ flora S~c. ~4 <br /> <br /> 3. PLANREVIEW SBCTION <br /> <br /> Marion County does not require a plan review. <br />I We will provide plan review service if you complete <br />I <br />Section 5tt and submit two (2) sets of plans and <br />I specifications with this application. <br />MU 1541 <br /> <br />A2. Add5% surcharg~ (.05 x Al) <br /> <br />Subtotal $..~iy..~_O <br /> <br />(Al + .25), if required ~ $.__ <br />C. Invostiga6oa Fa= (if required) $. <br />D. Reinspection Fee ($25.00) $___ <br /> <br /> -TOTAL AMOUNT DUI/ <br />Receipt No. ~ <br /> <br /> <br />