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FOR CITY VALIDATION[ <br />Reoeive~d by: <br />Date: <br /> <br /> MECHANICAL PERMIT APPLICATION <br /> Please complete all ~ections, I through 5 <br /> <br />MARION COIjNTY BUILDING INSPECTION <br /> COMMUNITY DEVELOPMENT CENTER <br /> 285 Church St NE * Room 132 PERMIT NO: <br /> Salem, OR 97301 <br /> <br />Date: <br /> <br />Issued by: <br /> <br />24 Hr Inspection Line: 58~-7904 <br />Off'tee: 588~5147 8:00a.m. - 4:30p.m. <br />FAX: 588-7948 <br /> <br /> 4. FE]~ SCHI~ (Complete and enter total in Al b~lo.w)f <br /> Xd <br /> RESIDE~AL Q COMM~RCI~ ~a~ <br /> USE OF STRUCTURE: ./ <br /> NEW ~3 ALTERATION C3 ADDITION ~ RELOCATION ~ <br /> GAS ~1 or ELECTRIC C3 <br /> <br />PERMITS ARE NON-TRANSI~RABLE AND EXPIRE IF WORK IS NOT ] <br /> STARTED wrrHIN 180 DAYS OF ISSUANCE OR IF <br /> WORK IS SUSPENDED FOR 180 DAYS. <br /> <br />2A. CONTRACTOR INSTALLATION ONLY <br />Contractor I Phone <br /> <br />Job No. <br /> <br />Contractor's Board Reg. No. <br /> <br /> No. X Fe~ ~ Sum <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 />~oor Furnace $ 6.00 <br />Suspended Heater $ 6.00 -- <br />Wall Heater $ 6.00 <br />Floor Mounted Heater $ 6.00 <br /> <br />HEAT pUrvip <br />under 3 Ton $ 6.50 <br />3 Ton and up $11.00 -- <br /> <br />AIR CONDITIONER <br />under 3 Ton $ 6.50 <br />3 Ton and up $1 ID0 -- <br /> <br />EvaDorativeCooler $ 4.50 -- <br />Commercial Exhaust System $ 4.50 <br />Commercial Hood and Exhaust $ 4.50 <br />Domestic Range Hood .~,,.~ 4.50 <br />F~r~ Damper $ 3.00 <br />Wood Stove/Fireplace $ 7.50 <br />Fur~ce Duels (Alteration~xtemion) $ 7.50 <br />Commercla~ / ladus~al lacifgrator $30.~0 <br /> <br />ADDITIONAL APPLIANCE8 <br />Gas Water Heater $ 7.50 -- <br />Gas Log Lighter $ 7.50 -- <br />Gas Barbeque $ 7.50 -- <br />O~her $ 7.50 <br /> <br />GAS PIPIN~ SYKI~M <br /> 1-4 outlets (per outlat) <br /> 4 and up outlets (p~r out/et) <br /> <br />$ 2.00 <br />S .50 __ <br /> <br />$ 3.00 <br /> <br />N/C <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 plans and <br /> specifications with this application. <br /> <br />MC 15-41 <br />P~v. 12/94 <br /> <br />5. FEES Al. Enter total of fees from Se~. #4 <br /> A2. Add5% s~hargg(.O5xAl) <br /> <br />,Subtotal <br /> <br />B, Enter 25% of line A1 for Plan Review <br /> (Al * .25), if required <br />C. lnveatigation Fee (if required) <br />D. Reinspection Fee ($25.00) <br /> <br /> TOTAL AMOUNT DUE <br />Receipt No. <br /> <br />$ <br />$ <br /> <br /> <br />