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FOR CITY VALIDATION <br /> <br /> Salem, OR 97301 <br /> <br />24 Hr Inaction L~o: 58~7~ <br />O~ 588-5147 8:~a.m.-4:30p.m. ISSU~ by: MARION COUN~ <br />F~: sss-794s BUILDING INSPECTION <br /> <br />MECHANICAL PERMIT APPLICATION <br />Please complete all Sections, I through 5 <br /> <br />1. LOCATION OF mgrALLAyION <br /> <br />D~cripl/~ffDditections <br /> <br />PERMITS ARE NON-TRANSFERABLE AND EXPIRE IF WORK 1S NOT [ <br />STARTED WITHIN 180 DAYS OF ISSUANCE OR IF <br /> WORK IS SUSPENDED FOR 180 DAYS. <br /> <br />2B. FOR OWNItR INSTALLATIONS <br /> <br />l~op~rty Owner (please print) <br /> <br />City/Stat~Jp <br /> <br /> 3. PLAN REVIEW 8~CTION <br />IMarion 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 />ME7 l:[-41 <br /> <br />4. FE]~ SCHEDULE (Complete and ent~ total in A1 below) <br /> <br /> RESIDENTIAL <br /> COMMERCIAL <br /> USE OF STRUCTURIE:' <br /> NEWel ALTERATION ~ ADDITION ~_,LOCAT1ON Cl <br /> GAS l~ or ELECTRIC ~ <br /> No. X Fee = Sum <br />BASE FIEE $10.00 <br /> <br />FORCED AIR FURNACE <br />up to 100,000 BTU $ 6.00 <br />ov~ l~O,O00 BTU s~' $ 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 />REAT pUMp <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 ~ $11,00 <br /> <br />EvaporativeCooler $ 4.50 <br />Commercial Exhsm~t System $ 4.50 <br />Commercial Hood and Exhaust $ 4.50 <br />Domestic Range Hood $ 4,50 <br />Domestic Exhaust Fans <br />and Dr~er Vents $ 3.00 <br />Fire Damper $ 3.00 <br />Wood StovedFireplaee $ 7,50 -- <br />Furnace Ducts (Alleeatin~Extension) $ 7.50 -- <br />Commercial [ Industrial Incinerator $30.00 <br /> <br />$7.50 <br /> <br />GAS PIPING SYSTEM lA omlets (per outleO <br /> 4 and up outlets (per outlet) <br /> <br />Appliance Vents not included in <br />~ appliance pennit <br /> <br />OTHER (as required by Ettil~qg Of~ei~0 <br /> <br />DWELLINO PERMIT LABEL # of Labels <br /> <br />5. FEt~S <br /> A 1. Enter total of fees from Sec, #4 <br /> A2. Add 5% sureharge (.OS x Al) <br /> <br />~ubtotal <br /> <br />$ 2.00 <br />$ .50 <br /> <br />$ 3.00 <br /> <br />B. Enter 25% of line A 1 for plan Review <br />(Al + .25), if required $ __ <br />C. Investigation Fee (if required) <br />D. Reitmpeetion Foe ($25.00) $ <br /> <br /> TOTAL AMOUNT DUE <br />Receipt No. <br /> <br /> <br />