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FOR CITY VALIDATION <br />Rooeived by:, <br />Date: <br /> <br />MARION COUNTY BUILDING INSPECTION <br />COMMUNITY DEVELOPMENT CENTER <br />285 Church St NE - Room 132 <br /> Salem, OR 97301 <br /> <br />24 Hr Inspection Lin~. 588-7904 <br />Off'wax 588-5147 8:00a.m.-4:30p.m. <br />FAX: 588-7948 <br /> <br />MECHANICAL PERMIT APPLICATION <br />Please complete all Sections, I through 5 <br /> <br />1. LOCATION OF INSTALLATION <br /> <br />IPERMITS ARE NON-TRANSFERABLE AND EXPIRE IF WORK IS NOT <br /> STARTED WITHIN 180 DAYS OF ISSUANCE OR IF <br /> WORK IS SUSPENDEI) FOR 180 DAYS. <br /> <br />2A. CONTRACTOR INSTALLATION ONLY <br /> <br />Property Owner (pleasepciat) <br /> <br />PERMIT NO: <br /> <br />Date: <br /> <br />Issued by: <br /> <br />4. F]~E SCHBDULB (Complete and enter total in Al be~ow) <br /> <br /> RESIDENTIAL I~l COMMERCIAL [-I <br /> USE OF STRUCTURE: <br /> NEW O ALTERATION ~ ADDITION ~ RELOCATION <br /> GAS O or ELECTRIC [2 <br /> No. X Fee = SUm <br />BASE FEE $10.00 <br /> <br />FORCED AIR FURNACE <br /> <br /> over 100,000 BTU $ 7.00 <br /> <br />Floor Fumac~ $ 6.00 <br />Suspended Heater $ 6.00 <br />Wall Heater $ 6.00 -- <br />Floor Mounted Hendr $ 6.00 -- <br /> <br />HEAT PUMP <br />under 3 Ton $ 6.50 <br />3 Ton and up $11.00 <br /> <br />AIR CONDITIOI~R <br />under 3 Ton $ 6.50 <br />3Tonand up SILO0 <br /> <br />EvaporativeCooler $ 4.50 <br />Commercial Exhauat System $ 4.50 <br />Commercial Hood and Enhau~t $ 4.50 <br />Domestic Range Hood $ 4.50 <br />Domestic Exhaus~ Fans <br />and Dryer V~nts $ 3.00 <br />Fig Damper $ 3.00 <br />Wood Stove/Fir~placc $ 7.50 <br />Furnace Ducts (Altctation~xteasion) $ 7.50 <br />Commercial / Indu~al Incinerator $30.00 <br /> <br />Gas Log Lighter $ 7.50 <br />Gas Eneocquc $ 7.50 -- <br />Other $7.50 <br /> <br />GAS PIPING SYSTEM <br /> 1~ oudcts (per outlet) ~ <br /> 4 and up ouOets (per oudet) <br /> <br />Appliance Vents not included in <br />an appliance permit <br /> <br />OTHER (as wquired by B~ilddt~ O~iaO <br /> <br />DWELLING PERMIT LABEL # of Labels <br /> <br />s 2.00 <br />$ .50 <br /> <br />$ 3.00 <br /> <br />N/C <br /> <br />3. PLAN REVIItW SI~CTION <br /> <br />IMarion County does not require a plan review. <br /> We will provide plan review service if you complete <br /> See~on 5B and submit two (2) sets of plans and <br /> specifications with this application. <br /> <br />MC 15-41 <br />R~v. 12/94 <br /> <br />A 1. Enter totel of fees ft~m Se~.//4 <br />A2. Add 5% st~charge (.05 x Al) <br /> <br />Subtotal <br /> <br />B. Enter 25% of line A1 for Plan Review <br /> (Al + .25), if required <br />C. Investigation Fee (if~equired) <br />D. Reinspectinn Fee ($25.00) <br /> <br /> TOTAL AMOUNT DUE <br />Receipt No. <br /> <br /> <br />