T
YPE OF WORK
N
ew construction
A
ddition/alteration/replacement
D
emolition
O
ther:
CA
TEGORY OF CONSTRUCTION
1- a
nd 2-family dwelling
Com
mercial/industrial
Ac
cessory building
M
ulti-family
M
aster builder
O
ther:
J
OB SITE INFORMATION AND LOCATION
J
ob site address:
C
ity/State/ZIP:
Sui
te/bldg./apt. no.: Project name:
C
ross street/directions to job site:
Subdi
vision: Lot no.:
T
ax map/parcel no.:
DE
SCRIPTION OF WORK
PR
OPERTY OWNER
T
ENANT
N
ame:
A
ddress:
C
ity/State/ZIP:
Phone:
( ) Fax: ( )
A
PPLICANT
C
ONTACT PERSON
B
usiness name:
C
ontact name:
Address:
C
ity/State/ZIP:
Phone:
( ) Fax: : ( )
E-ma
il:
C
ONTRACTOR
B
usiness name:
A
ddress:
C
ity/State/ZIP:
Phone:
( ) Fax: ( )
C
CB lic.: West Linn or Metro Lic:
Pr
int Name: Date:
Si
gnature:
(last updated 5/15)
COMMERCIAL FEE* SCHEDULE – USE CHECKLIST
Mechanical permit fees* are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
mechanical materials, equipment, labor, overhead, and profit.
Value: $
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
F
or special information use checklist.
Des
cription Qty. Ea. Total
Heatin
g/cooling
Fu
rnace
31.
00
Air
Conditioning **
25.
00
Gas
heat pump
25.
00
Du
ct work
19.
00
Hy
dronic hot water system
31.
00
R
esidential boiler (radiator
or hydronic)
25.
00
Un
it heaters (fuel-type, not
electric), in-wall, in-duct,
suspended, etc.
25.
00
F
lue/vent for any of above
19.
00
Other: 19.00
Oth
er fuel appliances
W
ater heater
19.
00
Gas
fireplace
31.
00
Flu
e vent for water heater
or gas fireplace
19.
00
L
og lighter (gas)
19.
00
W
ood/pellet stove
31.
00
W
ood fireplace/insert
31.
00
C
himney/liner/flue/vent
19.
00
Oth
er:
19.
00
E
nvironmental exhaust and ventilation
R
ange hood/ kitchen Eq.
19.
00
C
lothes dryer exhaust
19.0
0
Sin
gle-duct exhaust
(bathrooms, toilet
compartments, utility rooms)
13.
00
Attic/cr
awl space fans
13.
00
Oth
er:
19.
00
Fu
el piping ( 4 outlets)
9.
00
Each
additional gas outlet 2.00
Gas
Furnace, etc.
31.
00
Gas
heat pump
25.
00
W
all/suspended/unit heater
25.
00
W
ater Heater-Gas Fired
19.
00
Fir
eplace-Manufactured
31.
00
R
ange
19.
00
B
arbecue
19.
00
C
lothes dryer (gas)
19.
00
Other:
19.
00
ES
Su
btotal
M
inimum Permit Fee
100.
00
State s
urcharge (12
% of permit fee)
TO
TAL PERMIT FEE
This permit application expires if a permit is not obtained within 180 days after it has
been accepted as complete.
** A/C UNITS REQUIRE SITE PLAN
Mechanical
Permit Application
22500 Salamo Rd Box 900; West Linn OR 97068; Phone: 503-742-6055
Inspection Line: 1-8
88-299-2821
Forms available at http://westlinnoregon.gov
Radon Mitigation
31.00
**
click to sign
signature
click to edit
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