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HomeMy WebLinkAboutPermit Building 2013-5-8 • SPRINGFIELD 225 Fifth St • CITY OF SPRINGFIELD Springfield,OR 97477 i � _ Phone: 541-726-3753 OREGON Building / Residential Permit Inspection Phone:541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2013-00799 www.springfield-or.gov permitcenter @springfield-or.gov PROJECT STATUS: Issued ISSUED: 05/08/2013 EXPIRES: 11/03/2013 STATUS DATE: 05/08/2013 APPLIED: 04/19/2013 SITE ADDRESS: 2515 31ST ST,Springfield,OR 97477 SCOPE: Single Family Residence ASSESOR'S PARCEL NO: 1702193400400 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Addition to SFD . OWNER: BRANDT B J Phone Number: ADDRESS: PO BOX 1312 . SPRINGFIELD OR 97477 CONTRACTOR INFORMATION 11 Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone Electrical Contractor EASTSIDE ELECTRIC INC CCB 117770 10/04/2013 541-741-1499 Plumbing Contractor DON LEWIS PLUMBING SERVICE LLC CCB 167921 01/06/2014 541-688-1931 Mechanical Contractor MARSHALLS INC CCB 25790 12/23/2013 541-747-7445 • General Contractor HOME STYLES INC CCB 89219 02/19/2014 541-345-8000 INSPECTIONS REQUIRED Inspections 1020 Zoning Setbacks 1110 Footing Footing: After trenches are excavated. 1120 Foundation Foundation: After forms are erected but prior to concrete placement. 1220 Underfloor framing 1260 Framing Framing Inspection: Prior to cover and after all rough in inspections have been approved. 1410 Underfloor insulation 1420 Insulation VaporJ ail r/Thy , ^ • 1430 Insulation Wag�ot'OW rules adonm��,�wRlrinaulation�Prioroto cover. .,,,grrVf Center. -, t' �,ro,.,,. 1440 Insulation Ceiling�AR 9F2nn. rh OScefirr Insulatlbtl uppr to cover. 1460 Insulation uuao• You me `""'G tnrou9h OAR 95?�nn th a n..m Yobtain 1530 Exterior Shearwallber fn,„,_ sr. (Note:�tha 1+the rules by Tw//C,E; - 1999 Final Building Center is aypn tFirial�6uildin'af.(i�r all required•inspectiofs�lav yj r� sted and approved and 80 3 byildi9g is cor9lete. C /HOR/2E oHAL1 E ANA rBp D y p R�S Ask RM 7 S N�K Op NELI FOR T • Springfield Building Permit 5/8/2013 1:44:39PM - Page 1 of 2 SPRINGFIELD 225 Fifth St CITY OF SPRINGFIELD Springfield,OR 97477 Phone: 541-726-3753 OREGON Building / Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2013-00799 www.springfeld-or.gov permitcenter @springfield-or.gov By signature, I state and agree, that I have carefully examined the completed application and do hereby certify that all information hereon is true and correct, and I further certify that any and all work performed shall be done in accordance with the Ordinances of the City of Springfield and the Laws of the State or Oregon pertaining to the work described herein, and that NO OCCUPANCY will be made of any structure without permission of the Community Services Division, Building Safety. I further • certify that only contractors and employees who are in compliance with ORS 701.005 will be used on this project. I further agree • to ensure that all required inspections are requested at the proper time,that each address is readable from the street, that the permit card is located at the front of the property, and the approved set of plans will remain on the site at all times during construction. cJ°��( �iV�7 iie 511-13 Owner or Contractor Signature Date • • • • • • • • t ., Springfield Building Permit 5/8/2013 1:44:39PM 1) Page 2 of 2 SPRINGFIELD CITY OF SPRINGFIELD rl 225 Fifth St TRANSACTION RECEIPT Springfield,OR97477 541-726-3753 OREGON 811-SPR2013-00799 www.springfieldor.gov 2515 31ST ST permitcentera@spdngfield-or.gov RECEIPT NO: 2013000907 RECORD NO: 811-5PR2013-00799 DATE:05/08/2013 Io7 Yo}• DEL ;{nests .- ! _k.ic-a,E azdae,ACCOUNTCCODETRANS.CODE'1 L.L. .«:AMOUNT DUE Overwidth/Second Driveway 201-00000-428060 1144 54.00 Planning-Minor Review-UGB 100-00000-425002 1231 286.00 Residential.Fire(.05 Per Sq Foot) 100-00000-424005 9111 37.00 SDC: Improvement Cost-Storm Drainage 440-00000-448028 1176 158.33 SDC: Reimbursement Cost-Storm Drainage 441-00000-448029 1177 108.69 SDC:Total Storm Administration Fee 719-00000-426604 1180 13.35 State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 38.10 Structural Building Permit Fee 224-00000-425602 1002 317.50 Technology fee(5%of permit total) 100-00000-425605 2099 18.58 TOTAL DUE: 1,031.55 P.AYMENThTYP,EI' PAYOR CASweda etta ENiR COMMENTS- AMOUNT{FAID, Credit Card HOME STYLES INC - 1,031.55 082897 TOTAL PAID: 1,031.55 • • • • • • • • • • • SPRINGFIELD CITY OF SPRINGFIELD 41iTRANSACTION RECEIPT s;nngfieldpR 97477 .OREGON 541-726-3753 811-SPR2013-00799 www.spnngfield-or.gov 2515 31ST ST pennitcenter©springueld-or.gov RECEIPT NO: 2013000790 RECORD NO:811-SPR2013-00799 DATE:04/19/2013 DESCRIPTION V 'r,t. tse Vie`:-& ..`.,#J-Tr.' td 1 CCOUNROODE/-- ' NS CODE'_"f __"!_`i"AMOUNT, ,tai Structural Plan Review Fee Residential 224-00000-425602 1061 206.38 TOTAL DUE: 206.38 P.AYMENTsTiYP.E P.AYOR casNIER:.CCARPENiER COMMENTS= A_MOUNrPAID Credit Card Joel Crutchfield 206.38 376188 TOTAL PAID: 206.38 • Structural Permit Application SPRINGFIELD+WDER RTMENTJUSE'N Y . , rL CITY OF'SPRINGFIEL]D OREGON ' _ ; �s� Permit no.: S'3 _ 79 OREGON 225 Fifth Street♦Springfield,OR 97477•PH(541)726 3753•FAX(540726 3689 Date: el/i Gj/i3 This permit is issued under OAR 918-460-0030.Permits expire if work is not started within 180 days of issuance or if work is suspended for 180 days. `, a,'-. ' ''' 'LOCALa` GOVERNMEN7rAPP,ROVAL fr't +< fi.4ta ' ' aliger.N,�i.FECHEDULE; t,°„, ;,,'^ '.'„ 4r; This project has final land-use approval. L UaI atwo[nfo�ah a). '}, u ickiMi 1 ' .*' ; [1 Signature: Date: (a)Job description: D )79Ox1 / T✓t p 0 CZ This project has DEQ approval. n Occupancy '! Signature: Date: Zoning approval verified: ❑Yes ❑No - Construction type: V\� Property is within flood plain: ❑Yes ❑No Square feet: "' "°"`" =""'"` "°""°"'T '[*'€; ` '�rr Cost per square foot: --,�,��= ''3;,CATEGORY;„OE,:CONSTRUCTION c,��(�• �S p �1 • t Residential ❑Government ❑Commercial Other information: ....._ �.......... -.�.,,o..... ''�S„�"r,,,�g'����J�,B�SITE�INFORMATIONgAND,�LOCATIONO`ta Type of Heat: Job site Sp.-ins)address: S 15 . _j S- 54- Energy Path:i City: '_„t! State: G it ZIP:e]1y7 I ❑new Eta Iteration El.-addition ,—,`' Subdivision: rfjt- /9 cy Lot no00 L//° (b)Foundation-only permit? ❑Yes 0410 Reference: '70 3 axlot i20 L,1 Cr Q Total valuation: S�ryy_7 ` 7n 4 ,. f. -m._ ,,,[./' Ali a. s5I its- •s- -.-.es... -. £'$IG-''.'n�'ZC. X ni-s �1�...s8't; 22c`y��P-fff222-OP�ER ,;d,OWNERtE.Le i!`.'`'. 6.f, ,i.+,'a+i"t"Ff'w�Y! 2:,Budding$fees ffitte. `�" 1 IS�'' .�7 m''a 5^Y": nm". Name: IS) 'IXt.n' \- (a)Permit fee(use valuation table): $311 leg Address: ZS IS S i$f (b)Investigative fee(equal to[2a]): $ City: Sr,..„4 Lt i State: C(_ ZIP/7g7J (c)Reinspection($ per hour): j (number of hours x fee per hour) s Phone: SyI- 62$93 Fax: - - E-mail: (d)Enter 12%surcharge(.12 x[2a+2b+2c]): 533-1-2_ (e)Subtotal of fees above(2a through 2d): S Building Owner or Owner's agent authorizing this application: °3rplan r vi w"ffee's"""" -�s.-, s . (a)Plan review(65%x permit fee[2a]): $2CC0f dd Sign here: ?if r.J (b)Fire and life safety(40%x permit fee[2a]): $ ❑This install is being made on residential or farm property owned by (c)Subtotal of fees above(3a and 3b): $ me or a member of my immediate family,and is exempt from licensing pr...cl s" �'"'�""" " - '7�`•%' "�wl'Fy..iS3" '�'.- 'r ''4= i 4,Mlscellageous fees. ��,,;;.�„��. -. ";��•� requirements under ORS 701.010 . ° (a)Seismic fee, 1%(.01 x permit fee[2a1): $ a F;i17CONTRACTO NSTilIcai "�.` �. ;[' ';f-t 7 H.; (b)Technology fee,5%(.05 x permit fee[2a]): $ 15 75 Business name: a:f\a S.1-y } TOTAL.fees and surcharges(2e+3c+4a+4b): $ 6v6,y7 Address: 2.11ek Vdl t..nv City: Sk,.;..,)l.t(c State: G( ZIP: 'j7y7/ Phone: $-t(-gl'f--fti Is Fax: - - E-mail: Ct„40..,<h+F m,,:.1. a e..,.. - CCB license no.:\ S�iLIS \ - Print name: ggqdra A- (41,4-c...02-.,t,tL Signature: (I�t„p GAL fagrgSUB.CONT CTOR'[NFORMATION atzWti - Name CCB License# Phone Number Electrical C.,\r- A. 1/777° §-o- 11C:-Ii 71 Plumbing rt. lt`;f1% - 5k/-c -i931 - Mechanical kAtNShnliS ..5-4H- 747.its SPRINGFIELD 225 Fifth St 6 PhonCITY OF SPRINGFIELD Springfield,OR 97477 t E e: 541-726-3753 OR6GON Building / Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2013-00801 www•spnngfield-or.gov permitcenter @sptingfield-or.gov PROJECT STATUS: Issued ISSUED: 05/08/2013 EXPIRES: 11/03/2013 STATUS DATE: 05/08/2013 APPLIED: 04/19/2013 • • SITE ADDRESS: 2515 31ST ST,Springfield,OR 97477 SCOPE: Plumbing Only ASSESOR'S PARCEL NO: 1702193400400 TYPE OF STRUCTURE: Residential • PROJECT DESCRIPTION: Addition to SFD OWNER: BRANDT B J Phone Number: ADDRESS: PO BOX 1312 SPRINGFIELD OR 97477 . CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone Plumbing Contractor DON LEWIS PLUMBING SERVICE LLC CCB 167921 01/06/2014 541-688-1931 General Contactor HOME STYLES INC CCB 89219 02/19/2014 541-345-8000 • INSPECTIONS REQUIRED Inspections 3170 Underfloor Plumbing Underfloor Plumbing: Prior to insulation or decking. 3500 Rough Plumbing Rough Plumbing: Prior to cover and including required testing. 3999 Final Plumbing Final Plumbing: When all plumbing work is complete. By signature, I state and agree,that I have carefully examined the completed application and do hereby certify that all - information hereon is true and correct, and I further certify that any and all work performed shall be done in accordance with the Ordinances of the City of Springfield and the Laws of the State or Oregon pertaining to the work described herein,and that NO OCCUPANCY will be made of any structure without permission of the Community Services Division, Building Safety. I further certify that only contractors and employees who are in compliance with ORS 701.005 will be used on this project. I further agree to ensure that all required inspections are requested at the proper time,that each address is readable from the street,that the permit card is located at the front of the property, and the approved set of plans will remain on the site at all times during construction. Owner or Contractor Signature Date ATTENTION: Oregon law requires you to _ follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth ®SIPERMIT SHALL EXPIRE IF THE WORK in OAR 952-001-0010 through OAR 952-001- 0090. You may obtain copies of the rules by AUTHORIZED UNDER THIS PERMIT IS NOT calling the center. (Note: the telephone COMMENCED OR IS ABANDONED FOR number for the Oregon Utility Notification ANY 180 DAY PERIOD. Center is 1-800-332-2344). • • • Springfield Building Permit • 5/8/2013, 1:47:04PM Page 1 of 1 • SPRINGFIELD CITY OF SPRINGFIELD f °•.• - 225 Fifth St TRANSACTION RECEIPT Springfield,OR 97477 541-726-3753 OREGON 811•SPR2013-00801 www.springfield-or.gov 2515 31ST ST permitcenter©springfeld-or.gov RECEIPT NO: 2013000906 RECORD NO: 811SPR2013-00801 DATE:05/08/2013 g •r B3 PI" �.ir d ��..-.o •1• O g, .��4'.°a.1;Ci1.e:w_ f .ftfA N v ACCOUNT CODE/TRANS CODE N3R i a v4e '- AMOUNT DUE �?- Fixture 224-00000-425603 1005 189.00 State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 22.68 Technology fee(5%of permit total) 100-00000-425605 2099 9.45 TOTAL DUE: 221.13 PAY,MENT M- E P,AYOR cASRIERrccaRPENTER COMMENTS. - AMOUNTIMarl - _ Credit Card HOME STYLES INC 221.13 082897 TOTAL PAID: 221.13 Plumbing Permit Application ,s, DEPARTMENT,USE+ONLY •+ <n SPRINGFIELD - .,. + 4, a 'CITY OF SPRING FIELDAREGON ' �. Permit no.: , — ,70/,v - r Y `- t a* _—.± y,�� � l XY.{. 'pia-a_ I r 225 Fifth Street• Springfield,OR 97477 • P14(541)726-3753 • FAX(541)726-3689 Date: 1/ / // / /3 This permit is issued under OAR 918-780-0060. Permits are issued only to the person or contractor doing the work. Permits expire if work is not started within 180 days of issuance or if work is suspended for 180 days. AOCAL GOVERNMENT APPROVAL ,5+4; ,i. ; i`7,, rt , , . t/IF,EE'T.SCHEDULE?..-4Y� ,„' Zoning approval verified? ❑ Yes ❑No ,;Description Qty 'east cot l,'1 Sanitation approval verified? ❑ Yes ❑No New residential `.:CATEGORY'OF CONSTRUCTION-,7:':: ::r-- :;14; I bathroom/1 kitchen(includes:first ,IKiResidential ❑Government ❑Commercial bibs,feet maker, underfloor lines,hose $262.00 $ bibs, ice maker, underfloor low-point JOB SITE INFORMATION:I AND LOCATIONS „_ drains and rain-drain packages) Job site address: viS 318•} Sa. 2 bathrooms/I kitchen . $411.00 $ City: S� �j�,1; State:OR, ZIP: `Q 7y"7'� 3 bathrooms/1 kitchen $483.00 $ '�' Each additional bathroom(over 3) $104.50 $ Reference: Taxlot.: Each additional kitchen(over I) $104.50 $ ,,r ,r:`. "1"'DESCRIPTION 'OF.i.W ORK' t •. t?'r;li " Residential fire sprinklers(includes plan review) molt_ t .kk rod IVh r c....)3]O S•,n 1. 0 to 2,000 square feet $80.00 $ I '4WL we ey h Vrre� 2,001 to 3,600 square feet $128.00 $ > > . .:''•(`t ti ',PROPER17f OWNER'! `;` '” T,, ;. ,, 3,601 to 7,200 square feet $192.00 $ Name: .�. ` ,t'� 7,201 square feet and greater $255.00 $ �"'t nr„a, Manufactured dwelling or pre-Tab(circle one) Address: �is 9 Sf 51-, Connections to building sewer and water supply $80.00 $ City: _,_'0,..4 [� State:62 ZIP:5 7577 Commercial,industrial,and dwellings other than one-or Phone: Si- 19.4 •2.841 3. Fax: - - two-family E-mail: Minimum fee $80.00 $ This installation is being made on i esiden or farm property Each fixture `j $21.00 $ 3", owned by me or a member of my ' mediate fa ' and is Miscellaneous fees exempt from lice iii requirements under OAR 918-.' -0020. 100' storm,sewer,water line $83.50 $ Signature: /.-,L ' `e5 -.- _ Each fixture,appurtenance,and piping $21.00 $ "?- 4' •.. C TRACTOR^INSTALLATION i. tN Storm water retention/detentionfacility $21.00 $ Business name: ^ Irrigation systems $21.00 $ J�'^ I— '�• s m„�"f"') Piping or private storm drainage Address: lic3 k'.c.. systems exceeding the first 100 feet $21'00 $ City: 4ft State: Olt ZIP: " Specialty fixtures $21.00 $ �. Phone YY I�"6`1 I _ _ Reinspection(no.of hrs.x fee per hr.) $80.00 $ J - '1 Fax: Special requested inspections(no.of E-mail: [�;,,f} Q b hrs.x fee per hr.) - $80.00 $ cc; CCB license no.: BCD license no.: Each additional inspection:(1) $80.00 $ Plumbing license no Medical gas ptpmg ,t;1, w s k,, _ Minimum fee $ Print name: Enter value of installation and equipment$— Enter fee based on installation and equipment value. $ Signature: :- , ate '' ., `APPLICANT' USE r y ,+ -; =(`c (A) Enter subtotal of above fees J - (Minimum Permit Fee$80.00) $ /// (B)Investigative fee(equal to[A]) $ (C)Enter 12%surcharge(.12 x[A+B]) $ 22t" (D)Technology Fee(5%of[A]) $ /tit TOTAL fees and surcharges(A through D): $ 2712-7 440-2500-1(4/12013/COM) ' • • • • t SPRINGFIELD 225 Fifth St • CITY OF SPRINGFIELD Springfield,OR 97477 Phone: 541-726-3753 GREG°" Building I Residential Permit Inspection Phone:541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2013-00800 www.spnngfleld-or.gov permitcenterespringfield-or.gov PROJECT STATUS: Issued ISSUED: 05/08/2013 EXPIRES: 11/03/2013 STATUS DATE: 05/08/2013 APPLIED: 04/19/2013 SITE ADDRESS: 2515 31ST ST,Springfield,OR 97477 SCOPE: Mechanical Only ASSESOR'S PARCEL NO: 1702193400400 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Addition to SFD OWNER: BRANDT B J - Phone Number: • ADDRESS: PO BOX 1312 SPRINGFIELD OR 97477 CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone Mechanical Contractor MARSHALLS INC CCB 25790 12/23/2013 541-747-7445 General Contractor HOME STYLES INC CCB 89219 02/19/2014 541-345-8000 INSPECTIONS REQUIRED Inspections • 2200 Underfloor Mechanical Underfloor Mechanical. Prior to insulation or decking and including required.testing. 2300 Rough Mechanical Rough Mechanical: Prior to Cover 2999 Final Mechanical Final Mechanical: When all mechanical work is complete. By signature, I state and agree,that I have carefully examined the completed application and do hereby certify that all information hereon is true and correct, and I further certify that any and all work performed shall be done in accordance with the Ordinances of the City of Springfield and the Laws of the State or Oregon pertaining to the work described herein,and that NO OCCUPANCY will be made of any structure without permission of the Community Services Division, Building Safety. I further certify that only contractors and employees who are in compliance with ORS 701.005 will be used on this project. I further agree to ensure that all required inspections are requested at the proper time,that each address is readable from the street,that the permit card is located at the front of the property,and the approved set of plans will remain on the site at all times during •construction. • Owner or Contractor sigrafyrTION: Oregon law requires you ppte follow rules adopted by the Oregon Utility Nf OTIC Notification Center. Those rules are set forth �: • in OAR 952-001-0010 through OAR 952-001- THIS PERMIT SHALL EXPIRE IF THE WORT( 0090. You may obtain copies of the rules by AUTHORIZED UNDER THIS PERMIT IS NOT calling the center. (Note: the telephone �pfl/141ENCE® OR I� number for the Oregon Utility Notification \+ 1a ABANDONED FOR Center is 1-800-332-2344). oO DAY PERIOD. • • Springfield Building Permit 5/8/2013 1:45:27PM Page 1 of 1 • - SPRINGFIELD CITY OF SPRINGFIELD • 225 Fifth St OREGON TRANSACTION RECEIPT Spnngfteld,OR 97477 541-726-3753 811-SPR2013-00800 www.springfeld-or.gov 2515 31ST ST permitcenter©springfeld-ar.gov • RECEIPT NO: 2013000905 RECORD NO:811SPR2013-00800 DATE:05/08/2013 e • ? O -� c"t,..'. ciii 1`r °-- �`.w :ACCOUNT CODE/TRANS CODE . .:' AMOUNT DUE'` First Appliance Fee 224-00000-425604 1006 80.00 Range hood/other kitchen equipment 224-00000-425604 1006 14.50 Single-duct exhaust(bathrooms,toilet compartments, utility room! 224-00000-425604 1006 - 20.00 State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 13.74 Technology fee(5%of permit total) 100-00000-425605 2099 5.73 TOTAL DUE: 133.97 P.AYMEN TYRE _ PAYOR-__cnsNleR:OCARPERiER COMMENTS • AMOUNTPAID Credit Card HOME STYLES INC 133.97 082897 TOTAL PAID: 133.97 • • • • Mechanical Permit Application DEPARTMENT. USE ONLY <;,: s D tT hn•••° 4Wi{ �}:ut, , ...2�� 7�fl SPRINGF IE LD 7' Permit no.: S(3 - Fol'eITY OPSIPRINGEIELEVOREGON-51 ` A,wi ��/ �/ 225 Fifth Street♦ Springfield,OR 97477 ♦ PH(541)726-3753 ♦ FAX(541)726 3689 +F ,4.,,-.:. vat " Date: t ( This permit is issued under OAR 918-440-0050. Permits expire if work is not started within 180 days of issuance or if work is suspended for 180 days. '; ,• , x ,CATEGORY OF,,CONSTROCT.ION„, -'"ii ,s . 4 .: a > ,;`FEE SCHEDULE - si e - — - — ` r .Cost Total ❑Residential ❑Government ❑ Commercial :Residential rs =t , s,ti{r Qty : '. ea '- . _ .,.cast ,} _” JOB'SITE INFORMATION,AN LOCATION: w ,'s ,. First Appliance i/ $80.00 $77) Job site address: 2$ 15 3 15k s d-. Furnace/burner including ducts and vents City: Z14 Slater ZIP: 57y�) Up to 100k BTU/hr. / $18.50 $ 0 /i7— Over 100k BTU/hr. $22.00 .$ Reference: Taxlot.: . .. .,;-:24', -, r Heaters/stoves/vents '' , ; ?DESCRIPTIONOF WORKf z , Unit heater $18.50 $ Mcvt 5,1- cc r aria c c, >dc:I-- uaAC. Wood/pellet/gas stove/flue • $42.00 $ Repair/alter/add to heating appliance/ �. refrigeration unit or cooling system/ $80.00 $ . 1 .:.* ,.. ,_;�„ a;PROP,ERTYaOWNER ;�;-" ,r il,,c;t'-,�, �? absorption system Name: RJ ' ,-,,,,,,3\ Evaporated cooler $14.50 $ Address: 25i.S '31"' Vent fan with one duct/appliance vent Z $10.00 $Zo Hood with exhaust and duct . 7 $14.50 $/c/ 5-0 City: 5,n44,O State:A2 ZIP: 1 7(77 Floor furnace including vent $80.00 $ Phone4"((-']q(- 2543 Fax: - - Gas piping E-mail: One to four outlets $7.50 $ This installation is being made on property owned by me or a Additional outlets(each) $4.50 $ member of my immediate family, and is exempt from licensing Air-handling units,including ducts requirements un er ORS 701 010. Up to 10,000 CFM i $12.00 $ Signature: N)CO —d Over 10,000 CFM $22.00 $ M ' `� ` Compressor/absorption system/heat pump ' ; .xC , TRACTOR INSTALL`ATION� , r��' i ,.-:! Up to 3 hp/100k BTU $18.50 $ Business name: M o,rtil" 'I 7 — Up to 15 hp/500k BTU $32.00 $ Address: y HQ v[7�;- S i- Up to 30 hp/1,000 BTU $47.50 $ City: 5,��ri, c.,LID State: 6 2 ZIP: T 7'/Th _ Up to 50 hp/1,750 BTU $62.50 $ PhoneJT(-70- 7‘1411 Fax: - . Over 50 hp/I,750 BTU $104.50 $ E-mail: Incinerators Domestic incinerator $22.50 $ CCB license no.: •� :Commercia ' , ..�r� ws? . 11 - r. . ,`, ; ',:' Print name: Enter total valuation of mechanical system and installation costs$ Signature. Enter fee based on valuation of mechanical system,etc. $ ° "� :« l Cost Total Mlscellaneous,fees name Reinspection $80.00 $ Specially requested inspections(per hr.) $80.00 $ Regulated equipment(unclassed) $14.50. $ Each additional inspection:(1) $80.00 $ la , .. - ,.l'AFP