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FOR CITY VALIDATION [ <br />R~eiwd by: <br />Date: <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> COMMUNITY DEVELOPMENT CENTER <br /> 285 Church St NE, Room 132 ~RMIT NO: <br /> Salem, OR 97301 <br /> <br />24 Hr Int~rlion Lin~ 588-7904 <br />Off'w.o: 588-5147 8:00 a.m. = 4:30 p.m. <br />FAX: 588-7948 <br /> <br />Date: <br /> <br />Issued by: <br /> <br /> MECHANICAL PERMIT APPLICATION <br /> Please complete all ~ections, I through 5 <br /> <br />1. LOCATION OF INSTALLATION <br /> <br />PERMITS ?~RE NON-TRANSFF-RABLE AND EXPIRE IF WORK 1S NOT <br /> <br />2A. CONTRACTOR INSTALLATION ONLY <br /> <br /> 2B. FOR OWNER INSTALLATIONS <br /> Prope~y Owner ~ple~so print) <br /> ~lli~ Ad~ Ph~e <br /> Ci~/S~t~p <br /> <br /> ~nt's Si~tum: <br /> <br /> 3. PL~ ~EW SECTION <br />IMarion Co~ does not require a plan review. <br /> We will provide pl~ review se~ice if you complete <br /> S~fion 5B and submit ~o (2) see of pla~ and <br /> specifications wi~ ~s application. <br /> <br />~ 1541 <br /> <br />4. FEll SCHKDULll (Complete and ent~ total in A1 below) <br /> <br /> RESIDENTIAL f-I COMMERCIAL I-'1 <br /> USE OF STRUCTURe: <br /> NEW 121 ALTERATION 121 ADDITION 121 RELOCATION 121 <br /> GAS rq or ELECTRIC CI <br /> No. X Foe = Sum <br />BA~E 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 />Floor Furnace $ 6.00 <br />Suspended Heater $ 6.00 <br />Wall Heater $ 6.00 -- <br />Floor Mounted Heater $ 6.00 <br /> <br />HEAT POIdP <br />under 3 Ton $ 6.50 <br />3 Ton and up $ I 1.00 -- <br /> <br />AIR COI~)ITIOI~R <br />under 3 Ton $ 6.50 -- <br />3 Ton and up $11.00 <br /> <br />EvaponaiveCool~r $ 4.50 -- <br />Commercial Exlmuat System $ 4.50 -- <br />Commercial Hood ~l Exhamt $ 4,50 -- <br />Dom0stic Range Hood $ 4,50 <br />Domestic Exhaust Fans <br />~ad Dryer Vents $ 3.00 <br />Fir~ Damper $ 3~00 -- <br />Wood Stove~Fireplace $ 7.50 -- <br />Furnace Ducts (AIteration/Ext~.slon) $ 7.50 -- <br />Commercial ! Industrial Incinerator <br /> <br />OAS PIPINO SYffI~M <br /> 14 outlets (per oufl~0 <br /> 4 and up outlets C~r out~*t) <br /> <br />Appliance Vents not included in <br />an appliance permit <br /> <br />OTHER (as required by Buildiqg OI~L~I) <br /> <br />DWELLING PERMIT LABEL # of Labels <br /> <br />$ ZOO -- <br />$ .50 -- <br /> <br />$ 3.00 -- <br /> <br />NIC <br /> <br />5. FEES <br />A 1. Enter total of fees from Se~. iq $ <br />A2. Add 5% surcharge (.05 x Al) $__ <br />Subtotal <br /> <br /> B. Enter 25% of line A1 for plan Review <br /> (Al + .25), if required $__ <br /> C. Investigation Nee (if required) $__ <br /> D. Reinspectlon Fee ($25.00) $__ <br /> <br /> TOTAL AMOUNT DUE <br /> Receipt No. <br /> <br /> <br />