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]FOR CITY VALIDATION <br />Received by.'. <br />Date:. <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> <br />COMMUNrI~r'DEVELOPMENT CENTER <br />285 Church St NE · Room 132 <br /> S~lem, OR 97301 <br /> <br /> 2~1 hr. Inspection LIne3T3-4427 <br />Office: Pbone,S~-514? 8:00am - 4:30pm <br />FAX: ~-7948 <br /> <br /> I <br /> MECHANICAL PERMIT APPLICATION J <br /> Please complete all Sections, I through 5 <br /> <br />1. LOCATION OF INSTALLATION <br /> <br />PERMITS ARE NON-TRANSFERABLE AND EXPIRE IF WORK IS NOT <br /> STARTED ~ 1~0 DAYS OF ISSUANC~ OR IF <br /> WORK IS SUSPENDED FOR 180 DAYS. <br /> <br /> CONTRACTOR Ilq'8'rALLATION ONLY <br /> <br />Co..:,or <br /> <br />Contractor's License No. <br />co.~toe. ~o,~d ~:g..o. ] S'o ~-- ~ob No. <br /> <br />2B. FOR OWNER INSTALLATIONS <br />Property Owner (.ole~pr~ta) <br /> <br />Ivhiling Addreaz Phone <br /> <br /> Ci,y/S ta ~7'Zip <br /> <br /> Agent's Signature: <br /> <br /> 3. PLAN REVIEW SECTION <br />IMarion 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 /> specifications with this application, j <br /> <br />Date: <br /> <br />Issued by: <br /> <br />4. P~E SC]~I.I~JJULE (Complete ~nd enter mai in Al below) <br /> RESIDENTIAL ~-I COMMERCIAL ~ <br /> os~ o.v mmucruPm: <br /> NEW~LTERATION I~ ADDITION a RELOCATION n <br /> <br /> GAS rn or ELECTRIC C] <br /> No. X Fee = Sum <br />BASE FEE $10.00 <br /> <br />FORCED. AIR FURNACE .~ <br /> over 100,000 BTU $ 7.00 ._~____~) <br /> <br />Floor Furnace $ 6.00 <br />Suspended Heater $ 6.00 <br />Wall lies*er $ 6.00 <br />Floor Mourned Heater $ 6.00 <br /> <br /> I~AT PUMp <br /> under 3 Ton $ 6.50 <br /> 3 Ton and up $11.00 <br /> <br /> AIR COI~)ITIOI~R <br /> un~'3Ton ~ $ 6.50 l}:Oil° <br /> 3 Ton mid up ~ $11.00 <br /> <br />Ev~potaHwCooler $ 4.50 <br />C~mncvolal Exhaust System . $ 4.50 -- <br />Commercial Hood and E.x~mt $ 4.50 <br />Dom~tie Rmlg~ Hood $ 4.50 <br />Domestic Exlmu~ Fins <br /> <br />F'u~ Daraper $ 3.00 -- <br />Wood S tovedFir~p[ac~ $ 7.50 <br />Fuma¢~ Ducts (Alteratlon~xtensbn) $ 7.50 <br />Commercial ! ladus~al Incinerator $30.00 <br /> <br />ADDITIONAL APPLIANCES <br />Oas Log Lighter $ 7.50 -- <br />Other $ 7.50 <br /> <br /> 4 and up outlets (per outlet) $ .50 -- <br /> <br />Appllancc Veins not included in <br /> appliance permit $ ZOO __ <br /> <br />OTHER (as required <br /> <br />DWELLING PERMIT LABEL #of Labels ~ <br /> <br />5. FEES ' <br /> Al. r~,¢r ~ot~l orfee~ from See. ~ $ //~,OD <br /> A2. Add 5% s~ha~e (.05 x Al) $~ <br /> <br /> B. ~ter 25~ otlheA1 forP~ Review <br /> <br /> <br />