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HomeMy WebLinkAboutPermit Building 2013-6-4 • 'SPRINGFIELDA' 225 Fifth St CITY OF SPRINGFIELD Springfield,OR 97477 Phone: 541-726-3753 OREGON Building / Commercial Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2013-01125 www.springfeld-or.gov permitcenter©springfield-or.gov • PROJECT STATUS: Issued ISSUED: 06/04/2013 EXPIRES: 11/30/2013 STATUS DATE: 06/04/2013 APPLIED: 05/31/2013 SITE ADDRESS: 4095 MAIN ST,Springfield,OR 97478 SCOPE: Kitchen ASSESOR'S PARCEL NO: 1702314104500 TYPE OF STRUCTURE: Commercial PROJECT DESCRIPTION: Install a new Type 1 Grease duct hood Mechanical only electrical/and hood suppression system not included in permit OWNER: MILES INVESTMENTS LLC • Phone Number: ADDRESS: 2175 HWY 101 N • FLORENCE OR 97439 • CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone FM SHEETMETAL INC (LHR)Electrical G 657LHR 07/01/2014 541-726-3000 INSPECTIONS REQUIRED Inspections • - 2170 Fuel Burning Appliance 2250 Gas Piping 2255 Gas Pressure Test • 2260 Gas Service Gas Service: After line is installed and line has been connected to a minimum of one appliance including required testing. Presure test done at this point. 2300 Rough Mechanical Rough Mechanical: Prior to Cover 2310 Rough Gas • Rough Gas: After line is installed and required testing and capped if not attached to an appliance. 2530 Kitchen Exhaust/Commercial Hood 2995 Final Gas Final Gas: Wien all gas work is complete. 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 • constru on.A,nt 1TION: Oregppnn law_requires you to (I. C. rule bpte2i-by +le Oregon Utility Affc, 9V to .�Tt pies ar0 set forth �- f -0i' to Xtf�9 blb`fiiroucivol. iflsa-oo+- vK caner or Co&* uNgifim* btain copies of the rules by Date THIS PERMIT SHALE EXPIRE IF THE WORK calling the center. (Note: the t Notification AUTHORIZED UNDER THIS PERMIT IS NOT number for the Oregon Utility Notification Springfield Building Permit Center is 1-600-332-2344). COMMENCED OR IS ABANDONED FOR 6/4/2013 2:09:38P-ANY 180 DAY PERIOD. Page 1 of 1 • • ' SPRINGFIELD- CITY OF SPRINGFIELD ��tt -"#r^• 225 Fifth St VE�oN TRANSACTION RECEIPT Spnngfield,OR97477 541-726-3753 811-SPR2013-01125 www.spnngeeld-or.gov 4095 MAIN ST permitcenter©spnngfield-or.gov RECEIPT NO: 2013001110 RECORD NO: 811-SPR2013-01125 DATE:06/04/2013 DESCRIPTION'.latriri WAVIPM t` a tit'ACCOUNTCODE/TRANS CODE L_ `_fs„444.PlAMOUNT DUE 419 Mechanical Permit fee(based on value of work) 224-00000-425604 1006 162.61 State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 19.51 Technology fee(5%of permit total) 100-00000-425605 2099 8.13 TOTAL DUE: 190.25 ..PV MENT�TYP.E r ..PAYOR_- CnSRIER ECXRaEriER roc Tat.COMMENTS t r.`tz.,k t;r•i AMOUNT PAID-', ws. °xtt„ Credit Card Truaxx LLC 290.90 002593 - TOTAL PAID: 290.90 • . • Mechanical Permit Application ' DEPARTMENT USE ONLY SPRINGFIELD` a',CITY•OF,SPRINGFIELD,.OREGON �1 Pennit no 5'/1 Sae eon'-D //Z 5- .,i x„`c.i: .tea t a _., . .. _,..e x« 4.. 1 r' r .. .:rv_ F 225 Fifth Street•Springfield OR 97477• P11(541)726-3753 • FAX(541)726-3689 oaaGON Date: vp /3//`C/3 This permit is issued under OAR 918-440-0050.Permits expire if work is not started within I80[lays of issuance or if work is suspended for 180 days. CATEGORY OF CONSTRUCTION FEE SCHEDULE ❑Residential ['Government Commercial Residential Qty. Cost Total ea. cost JOB SITE INFORMATION AND LLOCATIION First Appliance $80.00 $ Job site address: yog5-/njN 4 5/ EOrr- Furnace/burner including ducts and vents OK n y7 Up to 100k BTU/hr. $18.50 $ City:51�t''II,zirLei_r State:Qq ZIP: 971/?♦ Over 100k BTU/hr. $22.00 $ Reference: I Taxlot.: Heaters/stoves/vents DESCRIPTION OF WORK Unit heater $18.50 $ 11J`,T1 c! , r e7 Z G"9 'fay Wood/pellet/gas stove/flue $42.00 $ I4006.-- dM1 it buU. /.y _. Repair/alter/add to heating appliance/ refrigeration unit or cooling system/ $80.00 $ j PROPERTY OWNER absorption system I Name: FiRlo/ t ST*DoA�Sp JA.�Lr Evaporated cooler $14.50 $ t t �0 �t7X ,�2- 7 Vent fan with one duct/appliance vent $10.00 $ Address: 7 City: J���Pt/1 Hood with exhaust and duct / $14.50 $ Ci J I State: 0� ZIP: Floor furnace including vent $80.00 $ Phone: ..?o3-7Q-/.40'; I Fax: - - Gas piping I E4if3if: 53 577?) - 7119 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 under ORS 701.010. Up to 10,000 CFM $12.00_ $ Signature: Over 10.000 CFM $22.00 $ CONTRACTOR INSTALLATION Compressor/absorption system/heat pump _ Business name: FM. eV Er- M TtlL lit Up to 3 hp/IOOk BTU $18.50 $ Up to 15 hp/500k BTU $32.00 $ Address: <btu, t <71 ^y Up to 30 hp/1,000 BTU I $47.50 $ City:`.-X IL.►w//LG!-[l- State:ok ZIP:Vey9/ Up to 50 hp/1.750 BTU - $62.50 $ Phone: S4)- 726-3000 Fax: 6.0 726 -' 4ZL Over 50 lip/1.750 BTU $104.50 $ E-mail: -J 1t ) ft,yvu1czcm, (tQ .cow Incinerators �n�1 O Domestic incinerator $22.50 $ CCB license no.: -t Commercial Print name: C VI to Enter total valuation of mechanical system and installation costs$ Signature: _....„-_-■ Enter fee based on valuation of mechanical system,etc. S Miscellaneous fees Items Cost Total ea. cost "' t Reinspection Seo.00 $ r116: y'De S'v2'IS'tW1)4 Specially requested inspections(per hr.) S80.00 $ 1`�tr' l�`Il 1 rby D Regulated dd additional (unclassed) $14.50 $ Y{e7 '�n Each fldditional inspection:(I) $80.00 $ APPLICANT USE .. _ (A)Enter subtotal of above fees(or enter set minimum fee of $80_00) $ (B)Investigative fee(equal to[Al) $ (C)Enter 12%surcharge(.12 x[A-f-B]) $ (D)Seismic fee, I%(.01 x [A]) $ (F)Technology Fee(5%of IA]) $ 440-2545-J(4/12013/COM) TOTAL fees and surcharges(A through E): $