Laserfiche WebLink
ceived By: I <br /> <br /> MARION COUNTY <br />BUILDING INSPECTION DIVISION <br /> 3150 Lancaster Dr. NE - Suite C <br /> Salem, Oregon 97305-1398 <br /> <br /> 24 HR Inspection Line 373-4427 <br />OITtce: phone 588-5147 8:00am. 4:30pm <br />['AX 585-7948 <br /> <br />q 'o : ECEIVED <br /> PERMIT NO: <br /> <br /> Date: MAY 8 199% ,! <br /> . ,MARION COUNTYkj~ <br /> ssu Oi'UmSlle gTm <br /> <br />MECHANICAL PERMIT APPLICATION <br />Please complete all Sections, 1 through 5 <br /> <br />1. LOCATION OF INSTALLATION <br /> <br />I ,. <br /> PE~ITS A~ NON-~S~ ~ E~E ~ WORK IS NOT <br /> ST~ W~ 180 DAYS OF ISSU~CE OR ~ <br /> WORK IS SUSP~ED FOR 180 DAYS. <br /> <br />2A. CONTRACTOR INSTALLATION ONLY <br /> <br />2B. FOR OWNER INSTALLATIONS <br /> <br /> Property Owner (please print) <br /> <br /> Mailing Address <br /> <br /> City, State, Zip <br /> <br /> O~e,e~'s Signature <br /> <br /> Agent's Signature <br /> <br />3. PLAN REVIEW 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 /> specifications with this application. <br /> <br />4. FEE SCHEDULE (Complete and enter total in A1 below) <br />RESIDENTIAL ~ CO1VIMERCIAL O USE: <br />NEW {~ ALTERATION {~ ADDmON {~] RELOCATION {~ REPLACE <br /> GAS ~ ELECTRIC ~ <br />BASE FEE ASSESSED ON ALL APPLICATIONS $10.00 <br /> <br />FURNACE -- OTY <br />FORCED AIR UP TO 100,000BTU x $6.00 =$- <br />FORCEDAIROVER 100,000 BTU x $7.00 =$ -- <br /> <br />FLOOR I~JRNACE x $6.00 = $ __ <br />DUCTS (ALTERATION/F~XTENSION) x $7.50 = $ __ <br /> <br />GASFLIRNACE(uptolCO,000BTU) I x $6.00 =$ ~.~ O <br />GAS FURNACE (over 100,000 BTU) x $7.00 = $ __ <br />GAS FIREPLACE/INSERT x $7.50 = $ __ <br />GAS WATER HEATER x $7.50 = $ __ <br />GAS LOG LIGH'[ER x $7.50 =$__ <br />GAS BARBEQUE x $7.50 = $ __ <br /> <br />GAS PIPING <br />mc~ o~d~t up to 4 o.tt~t~ _~ · $2.~0= S ~' 00 <br />Each additional oatlet over 4 outlets x $.50 = $ <br /> <br />SIJSFIgNDED BEATER x $6.00 = $ -- <br />WALL HEATER x $6.00 = $ __ <br />FLOOR MOUNTED x $6.00 = $ __ <br />HEAT PUMP <br />UNDER 3 TON x $6.50 ~ $ __ <br />3 TON AND MORE x $11.00 <br /> <br />AIR CONDITIONER <br />UNDER3TON -- / x $6.50 =$ ~'~ <br />3 TON AND MORE x $11.00 $ <br />EVAFORATIVE COOLER x $4.50 = $ <br /> <br />~ # of LaEals <br /> <br />5. FEES <br /> A I. Enter total of fees from Sec. gq <br /> <br /> A2. Add 5% surcharge (.05 x Al) <br /> Subtotal <br /> <br />B. Enter 25% of llne Al for Plan Review <br /> (Al + .25), if required <br />C. Investigation Fee (if reqai~ed) <br />D. Reinspection Fee ($25.00) <br /> <br />Receipt No,____ <br /> <br />TOTAL AMOUNT DUE <br /> <br />MC 15-41 7/97 <br /> <br /> <br />