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FOR CITY VALIDATION <br />Re~oived by: <br />Date: ' <br /> <br />COMMUNITY DEVELOPMENT CENTER <br /> <br />Salem, OR 97301 <br /> Dato: <br />24Hr Insp~;tion Line: 588-7904 MARION COUNTY <br />O~: 5~-5147 8:~a.m.-4:30p.m. ISSU~ <br />F~: 588-7948 <br /> <br /> MECHANICAL PERMIT APPLICATION <br /> P/ease complete all Sections, I through <br /> <br />1. LOCATION OF INSTALLATION <br /> <br />4. FEB $CHl~DUL]5 (C~mplete and enter total in Al below) <br /> RESIDENTIAL ~ COMMERCIAL~ <br /> USE OF STRUCTURE: <br /> NEW ~2 ALTERATION O ADDITION]~LOCATION ~2 <br /> OAS <br /> ELECTRIC/,~.~ No, X peg = 8urn <br /> or <br /> <br />BASE FEE $1o.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 Heater $ 6.00 <br />Floor Mounted Heater $ 6.00 <br /> <br /> HEAT PUMP <br />PERMITS APsE NON-TRANSFERABLE AND EXPIRE [F WORK IS NOT [ under 3 Ton $ 6.50 <br />STARTED WITHIH 180 DAYS OF ISSUANCE OR IF I 3 Ton and up $11.00 <br />WORK IS SUSPENDED FOR lBO DAYS. <br /> AIR CONDITIONER <br /> under 3 Ton $ 6.50 <br />2A, CONTRACTOR I~STALLATIO~ ONLY J 3 Ton add up ~7' $1L00 <br /> <br />Con,fac Ph~ Commercial Exhaust System $ 4.50 <br />Mailin$ Address j $ 4.50 <br /> <br />Commercial Hood and Exhaust <br />Furnace Duc~s (Alt eration/Ext e~sio n) $ 7.50 <br /> <br />2B. I~OR OWNER INSTALLATIONS <br /> <br />Property Owner (please print) <br />Mailing Addgss Phone <br />City/State/Zip <br />Owner's Signature: <br />Agent'B SignaVar~: <br /> <br />$ 7.50 <br /> <br />OAS PIPING SYSTEM <br /> 14 outlel$ (per udder) <br /> 4 and up outlet~ (per outlet) <br /> <br />Appliance Vents ~t ~cluded ~ "~ applia~e ~it <br /> <br />OTHER (as ~uimd by B~I~ O~eiaO <br /> <br />D~LLINO PB~ L~EL 8 of ~ls <br /> <br />$ 2,00 <br />$ .50__ <br /> <br />$ 3.00 -- <br /> <br />NIC <br /> <br />3. PLANRBVIBW $~CTION <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 1541 <br />Rev. l~J~l <br /> <br />5. FEI~8 <br /> A 1. Enter total of fees fiom S~¢. <br /> A2. Add 5% surcharge (.05 x Al) $~ <br /> ~b~al $ <br /> <br /> B. ~t~r 2.5% of lineAl forP~ew <br /> (Al + 25), if r~u~d $ <br /> C. Investigation ~e 6frequimd) <br /> D. Re~pecfion Fee ($25.~) <br /> <br /> TOT~ ~O~ <br /> R~eipt No. <br /> <br /> <br />