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FOR CITY VALIDATION{ <br />Received by: , <br />D~to: , { <br /> <br /> MARION COUNTY <br /> '"BUILDING INSPECTION DIVISION <br /> 3150 LANCASTER DR NE , SUITE C <br /> SALEM OREGON 97305-1398 <br /> <br /> 24 hr. iaq~tlon Line 3734427 <br /> Office: Phone ~88-5147 8:00am - 4:30pm <br /> FAX: S88-7948 <br /> <br />MECHANICAL PERMIT APPLICATION <br />Please complete a/I ~ections, I through 5 <br /> <br />L LOCATION OF INffrALLATION <br /> <br /> x \ <br /> <br />['pEP. MITS ARE NON-TRAIq~]da~ABLE AND EXP1RE IF WORK [S NOTI <br />~TARTED WITHIN 1~0 DAYS OF ISSUANCE OR IF <br /> WORK IS SUSPENDED FOE 180 DAYS. <br /> <br /> 2A. CONTRACTOR INSTALLATION ONLY <br /> <br />2B. FOR OWI~R INSTALLATIONS <br /> <br />Pmlnrty Owaer (~a~ prim) <br />Mailbag Addr~ } Phone <br />City/~tate/Zip <br /> <br />Own~'s Sisnatu~: <br /> <br />Agent's <br /> <br />3. PLANR1]VIEW SF~CTION <br /> <br />Marion County does not require a plgn 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 /> <br />MC 15-41 <br />REV 8/96 <br /> <br />Issued by: <br /> <br />4. FEE SCH~fl)ULB (Complete and enter total in Al below) <br /> <br /> RF_,~IDENTIAL ~ COMMERCXAL i-Ii <br /> USE. OF ~TRUCTUR~: ~;e~v--4-. <br /> NEW'C] ALTERATION [~'ADDITION C3RELOCATIONO <br /> GAS [~ or ELECTRIC O <br /> <br />BASE FEE <br /> <br />FORCBD AIR FURNACE <br />up to 100,000 YBTU $ 6.00 -- <br />ove~ 100,000 BTU $ 7.00 <br /> <br />Floer F, umace $ 6.00 <br />Suspended Heater $ 6.00 <br />Wall Heater $ 6.00 <br />Floor Mourned Heater $ 6.00 <br /> <br />RKAT PUblP <br />under 3 Ton $ 6.50 <br />3 Ton and up $11.00 -- <br /> <br />AIR CONDrrlON~R <br />under 3 Ton $ 6-50 <br />3Ton and up $11.00 <br /> <br />Ev,~ii,~C~oJer $ 4,50 -- <br />Commercial Exhaust System $ 4,50 <br />Commercial Hood and Exhausl $ 4.50 <br />]Domestic Range Hood $ 4.50 -- <br />Domestic Exhaust Fans <br />and I~Ter Vents $ 3,00 -- <br />Fire Damper $ <br />Wood Stove~Fireplace $ 7.50 <br />Furnace Duels (Alt~afion/Ext~asioa) $ 7,50 <br />Commemial ! lndu.lfia! ln¢inurator $30.00 -- <br /> <br />$ 7,50 <br />$ 7,50 <br />$ 7,~o 7-7G~ <br /> <br />$ .50 <br /> <br />$ 3.00 -- <br /> <br />NIC <br /> <br />AL Enter lotal o f fees from Sec.//4 <br />A2. Add 5% aurcluu~go (.05 x Al) <br /> <br />B. F:m~r 25% of line A l for Plan R~ei~w <br /> (Al + ~.5), ff requh~d <br />C. Investigation Fee (if required) <br />O. l~inspecdon Fcc <br /> <br /> TOTAL AMOUNT DUE <br />Rcccyt No. <br /> <br /> <br />