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~J~OR~ITY VALIDATION <br />Re~eivod by:. <br /> Date: <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> COMMUNITY DEVELOPMENT CENTER <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 /> MECHANICAL PERMIT APPLICATION <br /> Please complete all Sections, I through 5 <br /> <br />t, LOCATION OF INSTALLATION <br /> <br />PERMITS ARE NON-TRAnSFERABLE AND EXPIRE IF WORK IS NOT <br /> STARTED WITHIN 180 DAYS OF ISSUANCE OR IF <br /> WORK IS SUSPHND~ FOR 180 DAYS. <br /> <br />2A. COHTRACTOR INSTALLATION ONLY <br /> <br />Mailing Address <br />Conm~c~or's License No. <br />Cea~-ac~r's Boa~l Reg. No. /ob No, <br /> <br />2B. FOR OWlqHR INSTALLATION8 <br /> <br />Agent's Signature: <br /> <br /> 3. PLANREVIBW $tiCTION~~ <br /> oes <br />[ We will p~vide pl~ ~view ~ice if you complete <br />[ S~fion 5B and sub~t ~o (2) sets of p~ns and~ <br /> <br /> REV ~ <br /> <br />Date: rn <br /> r-r'l <br /> <br />Issued by: ~ <br /> <br />4. FEB SCHEDULE (Complete and enter total in A 1 b~w) <br /> RESIDENTIAL I-I COMMERCIA[~ <br /> USE OF STRUCTURE: Ct;* <br /> NEW [~ ALTERATION m ADDITION [~ RELOCATION <br /> GAS m or ELECTRIC m <br /> No. X Pe~ = 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 />FloorFurnace $ 6.00 -- <br />Suspended Hentsr $ 6.00 <br />Wall Henter $ 6.00 -- <br /> <br />HEAT PUMP <br />under 3 Ton $ 6.50 -- <br />3 Ton and up SILO0 -- <br /> <br />AIR COI~)ITIOI~gR <br />under 3 Ton $ 6.50 -- <br />3 Ton and up $11.00 <br /> <br />EvaporativeCooler $ 4.50 <br /> <br />Other $ 7.50 -- <br /> <br />GAS PIPING SYSTEM 1 ~ outlets (per outlet) <br /> 4 and up outlets (per outlet) <br /> <br />Appliance Vents not included in <br />an appliance permit <br /> <br />OTHER (as required by Bt~l~ O~eial) <br /> <br />DWELLINO PERMIT LABEL # of Label~ <br /> <br />$ 2.00 <br />$ .50 -- <br /> <br />$ 3.00 -- <br /> <br />N/C <br /> <br />5. FliES <br /> Al. Enter total of fccs from Sec. #4 <br /> AZ, Add 5% surcharge (.05 x Al) <br /> Subtotal $.__ <br /> <br /> B, Emer 25% of line Al for Plan Review <br /> (Al + .25), if required $__ <br /> C. Investigation Fc~ (if required) <br /> D. Rein~pection Fe~ ($25.00) <br /> <br /> TOTAL AMOUNT DU~ $__ <br /> Receipt No. <br /> <br /> <br />