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FOR CITY VALIDATION <br />Received by: <br />Date: <br /> <br />5 - <br /> <br />MARION COUNTY BUILDING INSPECTION <br />COMMUNITY DEVELOPMENT CENTER <br />285 Church St NE · Room 132 <br /> Salem, OR 97301 <br /> <br />IMECHANICAL PERMIT APPLICATION <br />Please complete all Sections, I through 5 <br /> <br />24 Hr In~pectinn Line: 588-7904 <br />Off'w©: 588-5147 8:00 a.m.- 4:30p.m. <br />FAX: 588-7948 <br /> <br />1. LOCATION OF IlqSTALLATION <br /> <br />D~cripfion/Ddh~cfion~ <br /> <br />PERMITS ARE NON-TRAHSFERABLE AND EXPIRE IF WORK IS NOT <br /> STARTED WITHIN 180 DAYS OF ISSUANCE OR IF <br /> WORK IS SUSPEHDED FOR 180 DAYS. <br /> <br />2A, CONTRACTOR IN$TALLATION ONLY <br /> <br />2B. FOR OWNER RqSTALLATIONS <br /> <br />Pmper~y Owner (ples~prim) <br /> <br />Mailing Addr~s Phone <br /> <br />City/State~rZip <br /> <br />Owner's Signature: <br /> <br />Agent's Si~mature: <br /> <br /> Issu~ bY~TARi0N UOU~1TY <br /> BUILDING t~SpF(~T~0bJ <br />4. F~ ~C~ (C~pl~te and em~ ~l ~ Al b~low) <br /> RE$IDE~I~ ~ COMMBRCI~ ~ <br /> USE OF ~RUCT~E: <br /> NEW ~ ~TION ~ ~D~ION~OCA~ON ~ <br /> GAS ~ or ~EC~IC ~ <br /> <br />B~E FEE $10.~ <br /> <br />FORCED AIR FURNACE <br />up to 100,000 BTU $ 6.00 <br />over 100,000 BTU $ 7.00 <br /> <br />Hoot Fumaoe $ 6.00 <br />Suspended Heater $ 6.00 <br />Wall Heater $ 6.00 <br />Floor Motmtad Heater $ 6.00 <br /> <br />HEAT pDMP <br /> under 3 Ton <br /> 3 Ton and up <br /> <br />AIR COb~ITIONER <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 Stove2Fireplaee <br />Furnace Ducm (Altexatinn/~xt ensin n) <br />Co,inner, iai / Industrial Incinerator <br /> <br />$ 6.50 <br />stt.oo/'Z~d <br /> <br />$ 6.50 -- <br />$11.00 -- <br /> <br />$4.50 -- <br />$ 4,50 -- <br />$ 4,5O -- <br />$ 4.50 -- <br /> <br />$ 3.00 -- <br />$ 7.50 -- <br />$ 7,50 -- <br />$30.00 -- <br /> <br />Gas Log Lighter <br />Gas Bavb~qu~ <br /> <br />$7.50 -- <br />$ 7.50 <br />$ 7.50 -- <br />$7.5O -- <br /> <br />OAS PIPING SYSTEM <br /> 14 ouflet~ (per outlet) <br /> 4 and up outleta (l~r outlet) <br /> <br />Appliance Ven~ not included in <br />an appliance permit <br /> <br />OTHER (as required by Build&~ O~eial) <br /> <br />DWELLING pERMIT LABEL # of Labels <br /> <br />$ 2.00 -- <br />$ 30 -- <br /> <br />$ 3.00 -- <br /> <br />3. PLAN,REYIEW SECTION <br /> <br />Marion County does not require a p!an review. <br />we will provide plan review service if you complete <br />Section SB and submit two (2) se~ of plans and <br />specifications with this application. <br /> <br />MC 15-41 <br />R~v. 12/94 <br /> <br />5. FEES <br /> <br /> A2. Add 5% surcharge (.05 x Al) <br /> ~bt~al <br /> <br /> B; ~ter25% 0flinoA1 for Pi~ Renew <br /> (Ai + .25)~ if ~i.d <br /> C. ~stiget~n ~ (ifgqal~) <br /> D. Ro~sgect~n F~ ($25.~) <br /> <br /> <br />