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ONLY[ MARION COUNTY BUILDING INSPECTION <br />FOR <br /> OFFICE <br /> USE <br />R~eived by:__ __ __ 220 High S~roet NE <br />Date: ~_. Salem, Oregon 97301 <br /> <br />MECHANICAL PERMIT APPLICATION ~% Code;~=~;;=.?,~S~8~e~4 ~J Date'" <br />Please complete all Sections, I through 5I ~,~,'~'~ ~ 2 1996 ~ssu,~' --by: <br />MARIOt COUNTY <br /> ,. ~OC^noN OF ~Sr^LLAnON BUll. DING <br /> <br />PE1LMIT$ ARE NON-TRANSFERABLE AND NON-REFUNDABLE AND <br />EXPIRE IF WORK IS NOT STARTED VvTII{IN I80 DAYS OF ISSUANCE <br />OR IF WORK tS SUSPENDED FOR 180 DAYS. <br /> <br /> ZA. CONTRACTOR INSTALLATION ONLY <br /> <br />Peri. it No. <br /> <br />ISPE CTJ04& sc.~v~rc~..~.~.,~ ~x, <br /> RESIDENTIAL [~ COMMERCIAL [] <br /> <br />USE OF STRUCTURE: <br /> <br />NEW [~J'ALTERATION [] ADDITION [] RELOCATION [] <br />GAS~or ELECTRIC[] NO. X ~ "' ~ <br /> <br />Contrncto~s License No. <br /> <br />FOR OWNER INSTALI~TIONS <br /> <br />Property Owner <br /> <br />Mailing Address <br /> <br />City/State/Zip <br /> <br />The installation is being made on pmpet~ I own which is not intended for sale, <br /> <br />Owners Signature <br /> <br /> 3. PLAN REVIEW SECTION <br /> <br />BASE ~'~ $10.00 <br /> <br />Forced Air Fuma~ $ 6.00 <br />100,000 BTU or less <br />Over 100,000 BTU -- $ 7.50 <br /> <br />Floor Furnace __ $ 6.00 <br />Suspended Heater __ S 6.00 <br />Wall Heater __ $ 6.00 <br />Floor Mounted Unit Heater / $ 6.00 <br />Heat Pump [] / Air Conditioner [] <br />Up to 3 Ton -- $ 6.00 <br />3 Tonto 15 Ton __ $1L00 <br />Evaporative Cooler __ $ 4.50 <br />Exhaust System, Commercial __ $ 4.50 <br />Hood and Exhaust, Commercial __ $ 4.50 <br /> <br />Domestic Range Hood __ $ 4.50 <br />Domestic Exhaust Fans <br />and Dryer Vents __ $ 3.00 <br />Ffi'e Damper __ $ 3.00 <br />WoodStove __ $7.$0 <br />Furnace Ducts (Alteration, Extension) __ $4.50 <br /> <br />Commercial or Induslrial Incinerator __ $30.00 <br /> <br />G~ Water Heater (relocation <br />or replacement) __ $ 7.$0 <br />Gas Connection <br />-per outlet, up to 4 f $2.00 <br />-over 4, $8.00 plus ea. <br />additional __ $ .50 <br /> <br />For the Installation, Relocation <br /> or Replacement ofea~ Appliance <br /> Vent not included in an <br /> Appliance permit. <br /> <br />Other (as required by Building Official) <br /> <br />__ $ 3.00 <br /> <br />We will provide plan review service if you complete Section <br />5B and submit two (2) sets of plans and specifications with <br />this application. <br /> <br />This optional plan review program does not suspend the <br />required submission of plans, and specifications when required <br />by the Oregon Structural Specialty Code, Chapter 53. <br /> <br />~IC' 13-41 <br />Rev. 5/93 <br /> <br /> <br />