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FOR CITY VALIDATION <br />Received by: <br />Date: <br /> <br />MECHANICAL PERMIT APPLICATION <br />Please complete all Sections, I through 5 <br /> <br />1. LOCATION OF INSTALLATION <br /> <br />Descdp~o~dDdir~tions <br /> <br />D.V LO.M ? <br /> <br /> 4. ~ SCH~ (Complete ~d en[~ ~l ~ Al below) <br /> <br /> RESID~I~ COMMBR~ ~ <br /> H~ OF ~RUCT~: <br /> NEW ~ AL~RATIO~ ~ ~D~ION ~ ~OCATION <br /> GAS ~ or ~E~IC ~ ~ <br /> <br />PERMITS ARE NON-TRANSFERABLE AND EXPIRE IF WORK IS NOT <br /> STARTED WITHIN 180 DAYS OF ISSUANCE OR IF <br /> WORK IS SUSPENDED FOR 180 DAYS. <br /> <br />ZA. COHTRACTOR INSTALLATION ONLY <br /> <br />Contractor's License No. <br /> <br />211. FOR OWHER INSTALLATIONS <br /> <br />Property Owner (please prim) <br />M~iling Address Phone <br />City/SmtetZip <br /> <br />Agent's Signature: <br /> <br />3. PLAN REVIEW SECTION <br /> <br /> No. X Fe~ = <br />/ BASE FEE $10.00 <br /> <br /> FORCED AIR FURNACE ~/ $ 6.00 <br /> up to 100,000 BTU <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 Heater $ 6.00 -- <br /> <br />HEAT PUMP <br />under 3 Ton $ 6.50 -- <br />3 Ton and up $11,00 -- <br /> <br />AIR CONDITIONER <br />under 3 Ton $ 6.50 -- <br />3 Ton and up $11.00 -- <br /> <br />EvaporativeCooler $ 4.50 <br />Commercial Exhaust System $ 4.50 -- <br />Commercial Hood and Exhaust $ 4.50 -- <br />Domestic Range Hood $ 4.50 -- <br />Domestic Exhaust Fans <br />and Dryer Vents $ 3.00 -- <br />Fig Damper $ 3.00 <br />Wood Stove/Fireplace S 7.50 -- <br />Furnace Ducts (Alteration/Extension) $ 7,50 -- <br />Commercial / Industrial Incinerator $30.00 -- <br /> <br />ADDITIONAL APPLIANCES <br />Oas Water Heater $ 7.50 <br />Gas Log Lighter $ 7.50 -- <br />Gas Barbequ~ $ 7.50 -- <br />O~her $ 7.50 -- <br /> <br />GA8 PIPINO SYSTEM <br /> 14 outlem (per outlet) <br /> 4 and up outlets (per outlet) <br /> <br />Appliance Venm not included in <br />an appliance permit <br /> <br />OTHER (as required by Bud{hog Ot~ctal) <br /> <br />DWELLINO PERMIT LABEL # of Labels <br /> <br />$ 2.00 <br />$ .50 -- <br /> <br />$ 3.00 -- <br /> <br />N/C <br /> <br />IMarion 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 />MC 1541 <br /> <br />A 1. Fmter total of fees imm See.//4 <br />A2, Add 5% surcharge (.05 x Al) <br /> <br />B. Enter 25% of line Al for plan Review <br />(A 1 + .25), if required <br />C. Investigation Fee (ifreqinrod) $__ <br />D. Reinspection Fee (I25.00) $__ <br /> <br /> TOT Otnvr Dim <br />Receipt No. <br /> <br /> <br />