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FOR CITY VALIDATION <br />Received by~ <br />Date: <br /> <br />COMMUNITY DEVELOPMENT CENTER <br />285 Church St NE · Room 132 PERMff NO: <br /> <br />Salem, OR 97301 <br /> <br /> 24 Hr loq~ct~on Lm~ <br />Ofl'~ 588-5147 8:00 n.n~ - 4:30 pan. <br /> FAX: 5~8-7948 <br /> <br />MECHANICAL PERMff APPLICATION <br />Ptease complete all Sections, I through 5 <br /> <br />1. LOCATION OF INSTALLATION <br /> <br />ii,dy[ITS ARE NON-TRANSI~.ABI-E AND ID(lIRE IF WORK IS NOT <br /> STARTED WITHIN 1~0 DAYS OF ISSUANCE OR tF <br /> WORK IS SUSP~qDED FOR 180 DAYS. <br /> <br />2.A.. COI~fI'RACTOR INSTA!-LATION ONLY <br /> <br />Mailin~ Addn:~ <br />Con,actor's L/c~n~ No. <br />C. on~tor's Boa~ I~. No. .lob No. <br /> <br /> Date: ~ <br /> Issued by: <br /> <br />4. Fl]l] SCHltDULI] (Complete mid enter total in Al below) ,d? <br /> <br /> aSS D.NT AL coM .c u. <br /> USE OF STRUCTURE: ~l~l.'soi~ <br /> NEW {~ ALTERATION ~ 'ADI~I~ON n RELOCATION El <br /> <br />GAS D or ELECTRIC El <br /> <br /> No. X PR - ~ <br />BASE FEE $10.~0 <br /> <br /> up lo 100,000 BTU $ 6.00 <br /> over 100.000 BTU $ 7.00 <br /> <br />Finor Furnace $ 6.00 <br />Suapco~ed Heat~ $ 6.00 <br />Wall Heater $ 6.00 <br />Floor Mourned H~atet $ 6,00 <br /> <br />HBAT PUMP <br />un&r 3 Ton $ 630 <br />3Ton and up $11.00 <br /> <br />.MR COHDITIOI~R <br />under 3 Ton $ 630 <br />3Ton and up $11.00 <br /> <br />EvaporaliveCooler $ 4.50 <br />C.~mmercial Exhau~ Syslem S 4.50 <br />Coo~eecial Hood and Ex~au~ $ 4.50 <br />Domestic Rmse Nood $ 4.50 <br /> <br />and Dr/er Ver~ $ 3.00 <br />Fir~ Dnmper $ <br />Wood slov~.'Pin'pu~ ~ $ 73O <br />Fumnce D~cta (Alle~aoon/l~l~ion) $ 7.50 <br />Commercial / Indm~nl Incinerator $.30.00 <br /> <br />ADDITIONAL APPLIANCES <br />Gas Water Hea~r $ 7.50 <br />Gm Log L.igin~ S 7.50 <br /> <br /> '" $7.50 <br /> <br />OAS PIPING SYSTEM <br /> I-4 outlets (p~ ~utl¢0 <br /> 4 and up oo0els (pet oollet) <br /> <br />Applmn¢0 Ven~ nol m¢inded m <br /> <br />OTHER (ts t~lulted by ,~mldiag Ot~ci~l) <br /> <br />S 2.00 -- <br />S .50__ <br /> <br />$ 3.00 -- <br /> <br />3. PLAN RBVIBW 8BCTION <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 pla~ and <br />specifications with this application. <br /> <br />5. FEES <br /> Al. Emer to~l of f~ fxom Sec. g4 <br /> A2. Add 5% ~ (.05 x Al) <br /> ~al <br /> <br /> B. ~25% ofl~ Al for P~ ~ew <br /> (Al + &5),if ~ <br /> C. ~tig~ ~ (if~) <br /> <br /> TOT~ ~O~ ~ <br /> R~ N~ , <br /> <br /> <br />