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FOR CITY VALIDATION <br />Received 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 Line 373-4427 <br />Office: Phone 588-5147 8:00am - 4:30pm <br />FAX: 588-7948 <br /> <br /> MECHANICAL PERMIT APPLICATION <br /> Please complete all Sections, I through 5 <br /> <br />.1.~OCATION OF ~ISTALLATION <br /> <br />2A. CONTRACTOR INSTALLATION ONLY <br /> <br />Mailing Addr~s ~---v~ ~ <br /> <br />/ob No. <br /> <br />Contraetor's License No. <br /> <br />~. OR OWNER INSTALLATIONS <br /> <br />PERMIT NO: <br /> <br />Date: <br /> <br />Issued by: <br /> <br />4. FEE SCHEDULE (Complete and enter~tal in A1 below) <br /> <br /> RESIDENTIAL D COM~RCIAL <br /> USE OF STRUCTURE: <br /> NEW ~ ALTERATION ~ ADDITION <br /> GAS ~ or ELECTRIC ~1 <br /> No. X Fez = Sum <br />BASE FEE $10.00 <br /> <br />FORCED AIR FURNACE <br />up~ 100,000BTU $ 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 Heater $ 6.00 -- <br /> <br />HEAT PUMp <br />under3Ton $ 6.50 -- <br /> 3 Ton and up $11.00 -- <br /> <br />AIR COHDITIONER <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 />F~re Damper $ 3.00 -- <br />Wood Stove/Fircplace $ 7.50 -- <br />Furnace Ducts (AReration/~xtension) $ 7.50 -- <br />Commercial / Industrial Incinerator $30.00 <br /> <br />ADDITIONAL APPLIANCES <br />Gas Water Heater $ 7.50 -- <br />Gas Log Lighter I $ 7.50 -- <br />G~ Bart~que $ 7.50 -- <br />Other $ 7.50 -- <br /> <br />GAS PIPING SY$TEM <br />1M outlets (p~routlet) ~ $ 2.00 -- <br />4 and up outlets (per outlet) $ .50 -- <br /> <br />Appliance Vents not included in <br />an appliancepermit $ 3.00 -- <br /> <br />OTHER (~s required by Bulldog Of~ciM) <br /> <br />DWELLING PERMIT LABEL # of Labels <br /> <br />N/C <br /> <br />5. F~S <br /> <br /> 3. PLAN REVIBW 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 />I specifications with this application. <br /> <br />REV 8/96 <br /> <br />Al. Enter total of fees from Se~. g4 <br />A2. Add 5% stagharge (.05 x Al) <br /> <br />Subtotal <br /> <br />B. Enter25% of lineAl forFlan Review <br />(Al + .25), if required $___ <br />C. Investigation Fee (if required) $___ <br />D. Reinspeetion Fee ($25.00) $___ <br /> <br /> TOTAL AIVIOUNT DUE $.__ <br />Receipt No. <br /> <br /> <br />