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FOR CITY VALIDATION <br />R~ved bi,: <br />Date: <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> COMMUNrFY DEVELOPMENT CENTER <br /> 285 Church St NE · Room 132 PERMIT NO: <br /> Salem, OR 97301 <br /> <br /> 24 hr, Inspection Line 373-4427 <br />Office: Phone 588-S147 8:00am - 4:30pm <br />FAX: S88-7948 <br /> <br />MECHANICAL PERMIT APPLICATION <br />Please complete all Sections, I through 5 <br /> <br />1. LOCATION OF INSTALLATION <br /> <br />PERMITS AR~ NON-TRANSFERABLE AND EXPIR~ IF WORK IS NOT <br /> STARTED WITI-I1N 1~ DAYS OF ISSUANCE OR 1F <br /> WOR~ IS SUSPENDED FOR 180 DAYS. <br /> <br />2A, CONTRACTOR IHSTALLATION ONLY <br /> <br />Mailin~ Address <br /> <br />Contractor's License No. <br />Contractor's Board P~g, No. ] Job No. <br /> <br />A~ent's Sisnature: <br /> <br />3. PLANRIiVIBW SECTION <br /> <br />Marion County does not require a plan review. <br />We will provide plan review service if you complete <br />Section 5B and submit two (2) sets of plans and <br />specifications with this application. <br /> <br />MC 15-41 <br />REV 8/96 <br /> <br />Date: <br /> <br />Issued by: <br /> <br />4. FEE SCH~DUL~ (Complete and enter total i~ Al 5elo~ <br /> <br /> RESIDENTIAL ~ COMMBRCI~ ~ <br /> U~ OF ~RU~: ~ <br /> NEW ~ AL~RATION ~ ~D~ON ~ ~OCATION ~ <br /> GAS ~ or ELE~IC ~ <br /> ~, X F~ = S~ <br />B~ FEE $1~ <br /> <br />FORCED AIR FURNACE <br />up to 100,000 BTU $ 6.00 <br />over 100,000 BTU $ 7.00 <br /> <br />Floor Furnace $ 6,00 <br />Suspended Heater $ 6.00 -- <br />Wall Heater $ 6,00 <br />Floor Mounted Heaser $ 6.00 <br /> <br />HEAT PUMP <br /> under 3 Ton <br /> 3 Ton and up <br /> <br />AIR CONDITIONER <br /> ~der 3 Ton <br /> 3 Ton and up <br /> <br /> and Dryer Vents <br /> <br />$ 6,50 <br />$11.00 <br /> <br />$ 6,50 <br />SILO0 <br /> <br />$ 4,50 <br />$4.50 <br />$ 4.50 <br />$ 4.5O <br /> <br /> 3,00 <br /> 3.00 <br />7.50 -- <br />7.5O -- <br />$~0.00 <br /> <br />Gas Log Lighter <br /> <br />$7.50 -- <br />$7.50 <br />$7.5O <br />$ 7.50 <br /> <br />GAS PIPING SYSTEM <br /> 1-4 outlets (per outlet) <br /> 4 and up outlets (per outlet) <br /> <br />Appliance Vents not included in <br /> <br />N/C <br /> <br />5. FEES <br /> Al. Enter total of fees from Sec. #4 <br /> A2, Add 5% su~harge (.05 x Al) <br /> <br /> D. Rcinspcction F~ ($25.00) <br /> <br /> TOTAL AMOUNT DUE <br /> <br /> <br />