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HomeMy WebLinkAboutPermit Mechanical 2013-5-28 t. SPRINGFIELD- 225 Fifth St '' CITY OF SPRINGFIELD Springfield,OR 97477 r.. Phone: 541-726-3753 OREGON Building / Commercial Permit • Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2013-01068 wvrx.springfieldocgov permitcenter @springfeld-orgov PROJECT STATUS: Issued ISSUED: 05/28/2013 EXPIRES: 11/23/2013 STATUS DATE: 05/28/2013 APPLIED: 05/28/2013 SITE ADDRESS: 3377 RIVERBEND DR,Springfield,OR 97477 SCOPE: Mechanical Only ASSESOR'S PARCEL NO: 1703220004102 TYPE OF STRUCTURE: Commercial PROJECT DESCRIPTION: Ductwork modifications for air register relocations OWNER: PEACEHEALTH Phone Number: ADDRESS: 123 INTERNATIONAL WAY SPRINGFIELD OR 97477 CONTRACTOR INFORMATION • Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone Mechanical Contractor COMFORT FLOW HEATING CO CCB 460 06/27/2013 541-726-0100 L. INSPECTIONS REQUIRED Inspections 2300 Rough Mechanical Rough Mechanical: Prior to Cover 2999 Final Mechanical Final Mechanical: Wien 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. / A s/z6/i3/z67,--,, O •.ero Contractor Signature Date • • _..; requires you to NOTICE: ATTENTION: Oregon law req follow rules adopted by the Oregon Utility THIS PERMIT SHAH EXPIRE IF THE WORK Notification Center. Those rules are set forth AUTHORIZED UNDER THIS PERMIT IS NOT N tW0 952 001 001 o through OAR 952-001- b R -r COMMENCED OR IS ABANDONED FOcog. You may obtain copies of the rules y ANY 180 DAY PERIOD. calling the center. (Note: the teleph <'� number for the Oregon Utility Notification • Center is j.8003322344)'' • Springfield Building Permit 5/28/2013 10:52:58AM Page 1 of 1 SPRINGFIELD --, CITY OF SPRINGFIELD 225 Fifth St TRANSACTION RECEIPT Spnngfield,OR 97477 {.i 541-726-3753 00.EGON 811-SPR2013-01068 www.springfieldor.gov 3377 RIVERBEND DR permitcenter©spnngfieldor.gov RECEIPT NO: 2013001039 RECORD NO:811-SPR2013-01068 DATE:05/28/2013 )e134;ll' [off L te ,-_� 'emu € � -r o j _ ,,ACCOUNT CODE/T' 'NS CODE falrAmouNT DUE=-1 Mechanical Permit fee(based on value of work) 224-00000-425604 1006 - 121.30 State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 14.56 Technology fee(5%of permit total) 100-00000-425605 2099 6.07 TOTAL DUE: 141.93 111 AYMENTitiTi PAOF casMER:06ARPEN7ER- COMME I AMQUNT?PAID Credit Card COMFORT FLOW HEATING CO Melai 141.93 05593Z Noel TOTAL PAID: 141.93 • Mechanical Permit Application DEPARTMENT USE ONLY £ fS+('h'+ SPRI GEIELD,€OREG Permit no.: S/ - /oo C/ // 225 Fifth Street• Springfield,OR 97477 • PH(541)726-3753 • FAX(541)726-3689 Date: J 2 1 3 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. 1.;,r , ,,, :-,CATEGORY'OF 'l o NsTiRUcTjo 2117 t. ? r :`FEE•'SCHEDULE y 3,i ❑ Residential ❑Government gl Commercial `Residential ? = ' r..z;-sve Qty - east coral - t `JO B SITE IFORMATION First Appliance $80.00 $ 33- Furnace/burner including ducts and vents Job site address: Jetz T�j��+ 1-7 g City:9wti(fle_ $, State: c512.- ZIP:9944,�— Up to IOOk BTU/hr. $18.50 $ Over 100k BTU/lir. .$22.00 $ Reference: /7o7 22o0 Taxlot Oc//O7 Heaters/stoves/vents k,c4tt DESCRIPTION' Unit heater $18.50 $ IhnIc IMQD tctci 1 1c,V0 Wood/pellet/gas stove/flue $42.00 $ Repair/alter/add to heating appliance/ refrigeration unit or cooling system/ $80.00 $ 't ,N,LLn''1 f 41 ti'4;Ci I+'PROPERTY ?OWNER a ' �4x ,' absorption system Name: v'le /r a- Cr7' Evaporated cooler $14.50 $ Address:/z,3 ilk-/7-2- C..in `f - Vent fan with one duct/appliance vent $10.00 $ Hood with exhaust and duct $14.50 $ City:-IV Et-O State: (l- ZIP:92'1 77 Floor furnace including vent $80.00 $ Phone: - - 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 under ORS 701.010. Up to 10,000 CFM $12.00 $ Signature: Over 10,000 CFM $22.00 $ >, ' CONT RAC TOR'IN STALLATION ° ,„$- L:_' Compressor/absorption system/heat pump Business name: r' - Up to 3 hp/100k BTU $18.50 $ crol?—'-S --L�� Up to 15 hp/500k BTU $32.00 $ Address: 1CS "Dp i Up to 30 hp/1,000 BTU $47.50 $ City: lZx^I FLT State:QfL ZIP: 473 Up to 50 hp/1,750 BTU $62.50 $ Phone%-7 y of 0 G Fax: - - Over 50 hp/I,750 BTU $104.50 $ E-mail: Incinerators Domestic incinerator $22.60 $ CCB license no.: Comrnercal Print name: 7T1zet EC.4C Enter total valuation of rnhani al system and installation costs$ 7 J525v Signatutg-���y Enter fee based on valuation of mechanical system,etc. $/2/2° rt Cost "Total - Mlscellaneous y'tCOSt� Reinspection $80.00 $ Specially requested inspections(per hr.) $80.00 $ Regulated equipment(unclassed) $14.50. $ Each additional inspection:(I) $80.00 $ "[cW3 to .r;i ' `'` r'APPLICANT`=aUSEt (A)Enter subtotal of above fees(or enter set 3 minimum fee of $80_00[ $ /Z/ (B)Investigative-fee(.,qual to[A]— __ $ (C)Enter 12%surcharge(.12 x[A-FBI) $ /`7 iL Seism ee, o x [A]) $ (E)Technology Fee(5%of[Al) $ l 02— 440-2545-1(4/1/2013/COM) TOTAL fees and surcharges(A through E): $ /rf( 5 S •