MECH - 1595566 - Laserfiche WebLink

Home Browse Search

FOR crrY USE ONLY i Received Byj. Date: Zoning By: .City: Receipt #: .Amount: $ MECHANICAL PERMIT APPLICATION Please ~omplete all Sections, l through 5 1. LOCATION OF INSTALLATION Parcel ID: Zip: pamel Owner: Cross Streot/Direcfions: Project Description: PERMITS ARE NON. TRANSFERABLE AND EXPIRE IF WORE IS NOT STARTED WITHIN 180 DAYS OF ISSUANCE OR IF WORE IS SUSPENDED FOR 180 DAYS. 2A. CONTRACTOR INFORMATION -- PLEASE INDICATE WHO IS DOING THE WORK Mailing Address: City: { ~)f~o'/~"1' State: Zip: Registration No.: Contractor's Signature: 2B. FOR OWNER INSTALLATION City: t~fftD/.& State: Phone: 1 am t~ PROP~ 0~ a~ ~n, ~si~ t~ completed st~m~ ~ will be my own gene~ contr~to~ I ~rs~ t~ I must mg~ter ~ a const~t~n cont~tor ~ the st~c~ is sold or o~ for sa~ befo~ or u~ ~leti~ lf l him s~contracto~. I wffi Mm ~ly s~con~to~ mgiste~d with t~ Constmction C~tors B~ I c~y m~ a~ do him a ge~ co~ractor w~ ~em~th~ E~c~n Cont~tors B~ ,will ,~d~y~ ~ Cou~ oS'~ Agent's Si~atu~ 3. PLAN REVIEW SECTION Marion County do~s not require a plan review. We will provide plan review service if you complete Section 5B and submit two (2) sets of plans and specifications with this application. MC 1541 Rev 9/98 MARION COUNTY BLrILDING INSPECTION COMMUNITY DEVELOPMENT CENTER 3150 Lancaster Dr. NE - Suite C, Salem, Oregon 97305 8:00am = 4:30pm 24 HR Inspection Line 373-4427 FAX 588-7948 )RESIDENTIAL ( )COMMERCIAL ( )GAS ( )ELECTRIC ) NEW ( ) ADDITION ( ) ALTERATION ) RELOCATION ( ) REFLACEMENT OTY ~ (includes duets / vents) ,~ . Forced Air up to 100,000 BTU ~ x $12.00 = $ -- Forced Air over 100,000 BTU -- x $15.00 = $ Floor Furnace -- x $12.00=$ Ducts (Alterations/Extenalo~) -- x $15.00 = $ -- Gas Furnace (up to 100,000 BTU) / x $12.00 = $ __ Gas Fumace (over l00.000 BTU) -- x $15.00=$__ GasFireplaee/lnsert -- x $15.00=$ Gas Water Heater -- x $15.00 = $ Gas Lng Lightcr -- x $15.00=$ Gas Barb~que -- x $15.00 = $__ Oas Piping Each catlel up to 4 outlets ~ x $4.00 = $ -- Each additional outlet over 4 outlets -- x $1.00 = $ -- Hearts Suspended Heater -- x $12.00 = $ -- Wall Heater -- x $12.00 = $ -- Pioor Mounted Heater -- x $12.~0=$__ H~at Pmnn Under3Ton -- x $12.00=$__ 3TonafldMor¢ -- x $22.00=$__ Undcr3Ton -- x $15.00=$__ 3 Tc~ and More ~[ x $22.00 = $ -- Evaporative Cooler -- x $9.00 = $ .-- Coml Exhaust System __ x $9.00 = $ -- Coral Hoed & F~,haust -- x $9.00 = $ -- Domestic Range Hood (include~ ducts) -- x $9.00 = $ -- Domestic Exhaust Fans -- x $6.00 = $ Dome~ic Dryer Vents x $6.00 -- $__ Applianc~ Vents installed and not included In an apptiance [~xmit -- x $6.00=$__ Woodstove / Fireplace -- x $15.00 = $ Fire Damper -- x $6.00 = $ Coral ! Industrial Incinerator -- x $60.00 -- $ One,'l'~oFam~l)wdlingFee:Squa'eFeec -- x $ .04=$__ Dwalling Permit Labels #of Labels __@ $ N/C (For New Dwellings Only) Other (as required by the Building Official) $ __ BASE FEE Assessed on ALL APPLICATIONS: $ Al. Enter total of fees from Sec. ~4 A2. Add State Surcharge (.05% x Al + Boa~ Fee) B. Enter 30% of line Al for Plan Review C. Investigation Fee (if required) D. Reinspeetion Fee ($50.00) E. Additional Plan R,view ($62.50/hr, minimum one-half hour) F. Inspection for which no fee is s~cificagy indicated,{i~ * ($62.50/hr, minimum one hour) G. Inspection Outside Normal Business Hours, ($62.50/hr, minimum two hours) H. Seismic Fee (.0~% x Al)) $ __ $__ $__ $__ $__ $__ TOTAL AMOUN~