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FOR CITY VALIDATION <br />Received by: <br />Date: <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> COMMUNITY DEVELOPMENT CENTER PERMIT NO: <br /> 285 Church St NE · Room 132 <br /> Salem, OR 97301 <br /> <br /> 24 hr. Inspection Line 373-4427 <br />Office: Phone 588-5147 8:00am - 4:30pm <br />FAX: 588-7948 <br /> <br />Dine: <br /> <br />Issued by: <br /> <br /> MECHANICAL PERMIT APPLICATION <br /> Please complete all Sections, I through 5 <br /> <br />1. LOCATION OF INSTALLATION <br /> <br />PERMITS ARE NON-TRANSFERABLE AHD EXPIRE IF WORK IS NOT <br /> STARTED WITHIN 180 DAYS OF ISSUANCE OR IF <br /> WORK IS SUSPENDED FOR 180 DAYS. <br /> <br />2A. CONTRACTOR INSTALLATION ONLY <br /> <br />2B. FOR OWNER INSTALLATIONS <br /> <br />3. PLAN REVIEW SECTION <br /> <br />Section 5B and submit two (2) sets of plans and <br />specifications with this application. <br /> <br />Marion County does not require a plan review. <br />We will provide plan review service if you complete <br /> <br />MC 1541 <br />REV 8/96 <br /> <br />4. FEE SCHEDIJI,E (Compteto and enter totalin Al below) <br /> RESIDENTIAL ~1 COMMERCIAL ~ <br /> USE OF STRUCTURE: ~6~H'P.'~ ~.~Qo~,~ noel~ <br /> NEWel' ALTERATION.-~ ADDITION ~1 RELOCATION <br /> GAS ~ or ELECTRIC ~q <br /> No. X Fee = Sum <br />BASE FEE $10.0O <br /> <br />FORCED AIR FURNACE <br /> up to 100,000 BTU <br /> over 100,000 BTU <br /> <br />Floor Furnace <br />Suspended Heater <br />Wall Heater <br />Floor Mounted Heater <br /> <br />$ 6.00 <br />$ 7.0O ~ <br /> <br />$ 6.00 -- <br />$ 6.00 -- <br />$ 6.00 __ <br />$ 6.00 <br /> <br /> $ 6.5o __ <br /> $1 1.00 __ <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 /> $30.00 __ <br /> <br /> $ 7.50 __ <br /> $ 7.50 <br /> $ 7.50 <br /> $7.50 <br /> <br /> $ .50 ~. <br /> <br />HEAT PUMP <br /> ~mder 3 Ton <br /> 3 Ton and up <br /> <br />AIR CONDITIONER <br /> under 3 Ton <br /> 3 Ton and up <br /> <br />EvaporativeCooler <br />Commercial Exhaust System <br />Commercial Hood and Exhaust <br />Domestic Range Hood <br />Domestic Exhaust Fans <br /> and Dryer Vents <br />Fire Damper <br />Wood Stove/Fireplace <br />Furnace Ducts (Alteration/Extension) <br />Commercial / Induxtrial Incinerator <br /> <br />ADDITIONAL APPLIANCES <br /> Gas Water Heater <br /> Gas Log Lighter <br /> Gas Batbeque <br /> O~her <br /> <br />GAS PIPING SYSTEM <br /> 14 outlet~ (per outlet) <br /> 4 and up outlet~ (per outlet) <br /> <br />Appliance Vents not included in <br />an appliance permit $ 3.00 -- <br /> <br />OTHER (as required by Buile~t~, Ol~cial) <br /> <br />DWELLING PERMIT LABEL # of Labels <br /> <br />5. FEES <br />Al. Enter total of fees from Sec. #4 $.__ <br />A2, Add 5% surcharge (.05 x A 1) <br /> Subtotal $.__ <br /> <br /> B. Enter 25% of line Al fo~ Plan Review <br /> (Al · .25), if required $__ <br /> C. Inveatigation Fee (if required) <br /> D. Reinspection Fee ($25.00) <br /> <br /> TOTAL AIvIOUNT DUE <br /> Receipt No. <br /> <br /> <br />