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FOR CITY VALIDATION <br /> Received by: <br /> <br /> IMECHANICAL PERMIT APPLICATION <br /> Please complete all Sections, I through <br /> <br /> 1. LOCATION ON INSTALLATION <br /> <br />I~ ~ NON-~S~B~ ~ ~ · WORK lS N~ <br /> ~ <br /> W~ IS SUS~ ~R 1~ DAYS, <br /> <br /> ~. CO~CTOR ~TION O~Y <br /> <br />Contractor's Lie ~.se No. <br /> <br />218. FOR OWNBR INSTALLATION8 <br /> <br />Prop~my Owner ~le~ print) <br /> <br />Mailin$ Address I I~ooe <br /> <br />Ciiyl$~ale/Zip <br /> <br />Own~'s Signamr~: <br /> <br />Agent's Sig~mium: <br /> <br />MARION COUNTY BUILDING INSPECTION <br />COMMUNITY DEVELOPMENT CENT~iR <br /> 285 Church St NE · Room 132 <br /> Salem, OR 97301 <br /> <br />24Hr lnsj~:tJoa Lin~ S88-7904 <br />Offio~: S88-S147 8:00n.m.-4:3Op.m. <br />FAX: ~88-79~8 <br /> <br /> Issued ~ <br /> BUILDING INSPEC. TIF)N <br />4. ~B ~HIiDULB (Complete ~d ~ ~1 ~ Al be~w) <br /> ~DE~I~ ~ COMM~RCI~ ~ <br /> USE OF ~RU~: <br /> ~ ~ ~TION ~ ~D~ON~CA~ON ~ <br /> GAS ~ ~IC ~ <br /> N~ X F~ - 8urn <br />B~E F~ $10.m <br /> <br />FORCED AiR FURNACE <br />up to 100,000 BTU $ 6.00 <br />over 100,000 E'TU $ 7.00 <br /> <br />Floor Fmmace $ <br />Suspended Heater $ 6.00 <br />Wall Heater $ 6.00 <br />Floor Moun~d Healer $ 6.00 <br /> <br />H~AT PUMP <br />md~r 3 Ton $ 6.50 <br />$ Ton and up $11.00 <br /> <br />MR COI'~ITIONER <br />under 3 Ton $ 6J0 <br />3 Ton and up <br /> <br />Bv~orativcCoolor $4.~0 <br />Commercial Exhaust System $ 4.50 <br />Commercial Hood and Exhaust $ 4.50 <br />Dom~tlc Range hood $ 4.50 <br />Domestic Er, hausl Faro <br />and D~er V~0s $3.00 <br />F'~ Dsmper ~.~ / ~'~2)~ff O/.~ . $3.00 <br />Wood 8 ~o',~Pir~plac~ ~' ~/~'/,~ ,~' E~ ~ $730 <br />Furnace Ducts (A Iterat ion/Exteosion) $ 7.50 <br />Cc~uaet~ial I h~t~ lncineraWr $,30.00 <br /> <br />ADDITIONAL APPLIANCB8 <br />Gm Water ltea~r $ 7.50 <br />Gm Log Lighter $ 7.50 <br />G~ Barbeqtu~ $ 7.50 <br />O~r $73O <br /> <br />OAS PIPINO 8YBTBM <br /> 1-4 oulle~ (~r outlet) <br /> 4 and up outlets (p~ outlet) <br /> <br />A~mi~ce V~ ~t ~1~ ~ <br /> ~ ~pl~e p~t <br /> <br />$ 2.00 <br />$ 30 <br /> <br />$ 3.00 <br /> <br /> 3. PLAN RBVIBW SBCTION <br />] Marion County does not .require a. plan review. <br />J We will provide plan review service if you complete <br />I Section 5B and sul~fit two (2) ~t~ of plato and <br /> specifications with this application. <br /> <br />$. PEHS <br /> Al. Hnter tote! o~ecs £rom Sec. ~4 <br /> A2. Add 5~ m~ha~ (~5 x A 1) <br /> <br /> B. ~r25~ of I~e A1 for P~ ~w <br /> <br /> TOT~ ~O~ D~ <br /> <br /> <br />