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FOR CITY VALIDATION [ Received by: Date: COMMUNITY DEVELOPMENT CE~R PE~Mff NO: ~5 ~urch St NE · R~m 132 S~em, OR 97301 Date: ~ hr. Inspection Line 373~27 O~: Phone 588~147 8:00am - 4:30pm ~SU~ by: F~: 588-7948 MECHANICAL PERMFI' APPLICATION Please complete all Sections, I through $ : 1. LOCATION OF INSTALLATION PERMITS AHD EXPIRE IF WORK IS NOT ARE NON-TRANSFERABLE STARTED WITHIN 180 DAYS OF ISSUANCE OR IF WORK IS SUSPI~DED FOR 1 ~0 DAYS. 2A. COI~H'RACTOR INSTALLATION ONLY Conlrnctor's Board Reg. No. lob No. 2B. FOR O~-NER INSTALLATIONS Pmpet~y Owner (pleaseptit~) Ci~y/$ ta~2Zip Owner's Signntu~e: Agent's Signature: 3. PLANREVIEW SECTION IMarion County does not require a plan review. We will provide plan review service if you complete Section 5B and submit two (2) sets of plans and specifications with this application. MC 1541 REV 8~6 4, FEE SCHEDULE (Complcto nnd enter total in A1 below) RESIDENTIAL ~ COMMBRCXAL f-~ USE OF STRUCTURE: NEW C] ALTERATION D ADDITION D RELOCATION GAS [~ or ELECTRIC D BASE FEE No. X Pe~ ~ FORCED AIR FURNACE up to 100,000 BTU $ 6.00 over 100,000 BTU $ 7.00 Floor Furnace $ 6.00 Suspended Heater $ 6.00 Wall Healer $ 6.00 Floor Mcunted Heater $ 6.00 HEAT PUMP under 3 Ton 3 Ton and up AIR CONDITIONER u~der 3 Ton 3 Ton and up EvaporativeCooler $ 6.50 -- $11.00 $ 6.50 $11.00 -- $ 4.50 -- $ 4.50 -- $ 4.50 $4.50 $ 3.00 $ 3.O0 $ 7.50 $7.50 $30.00 $7.50 -- $7.50 $7,50 -- $ 7.50 -- GAS PIPING SYSTI~M 14 outlets (per outlet) 4 and up ouflelz (per outle0 Appliance Ven~ not includ0d in aa appliance permit OTHt~R (as required by B~l~g Ol~cia O DWELLING PERMIT LABEL # of Lab~l~ $ 2.00 $ 30 -- $ 3.00 -- N/C