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MARION COUNTY BUILDING INSPECTION COMMUNITY DEVELOPMENT CENTER 285 Church St NE · Room 132 PERMff NO: Salem, OR 97301 24 hr. Inspection Line 373-4427 Office: Phone 588-5147 8:00am - 4:30pm FAX: 588-7948 Date: Issued by: MECHANICAL PERMIT APPLICATION Please complete all Sections, I through 5 ~OF IHSTALLATION Property Owner~Phon~ Cross ~tree~Directio~: lob Descri tion: 2A. CONTRACTOR INSTALLATION ONLY Mailing Address Owner's Signat~ Agent's Signature: 4. FEE SCHEDULE (Complete and enter total ia A1 below) RESIDENTIAL ,~[ . .COMMERCIAL [--I .' NEW El ALTERATION ~if AI~DrrION i~l RP..LOCATION ~1 GAS [~ or ELECTRIC rq No. X F~o = ~um BASE FEE $10.00 FORCED AIR FURNACE up to 100,000 BTU $ 6.00 over 100,000 BTU $ ZOO Floor Furnace $ 6.00 Susl~nded Heatsr $ 6,00 Wall Heater $ 6.00 Floor Mourned Heater $ 6.00 HEAT pUMP u~der 3 Ton 3 Ton and up AIR CONDITIOI'~R under 3 Ton 3 Ton and up Evaporativ~Cool~r Commercial Exhaust System Commercial Hood and Exhaust 6.5o d,.qo SILO0 -- $ 6.50 SILO0 $ 4.50 -- $ 4.50 -- $ 4.50 -- $ 4.50 -- $ 3.00 $ 3.00 $7.50 $7.5O $30.00 $7.50 $ 7.50 $7.50 $7.5O GAS PIPING SYSTEM 14 outlets (p~r outlel) 4 and up outlets (per outlet) Appliance Vents not included in an appliance permit OTHER (as required by Build~t~ Of~iaO DWELLING PERMIT LABEL # of Labels $ 2.00 -- $ .50 $ 3.00 -- 3. PLANREVIEW SECTION Marion County does not require a plan review. We will provide plan review service if you complete Section 5B and submit two (2) sets of plans and specifications with this application. MC 1541 REV 8/96 5. FEES Al. Enter total of fe.~ from Sec. #4 $.~_ A2. Add 5% surcharg~ (.05 x Al) $ ~ubt~tal $ B. Enter 25% of line A 1 for Plan Review (A 1 + .25), if required $ C. Investigation Fee (if required) $ D, Reimpeetion F¢o ($25.00) $ TOTAL AMOUNT DUE $.__ Receipt No.