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HomeMy WebLinkAboutPermit Mechanical 2013-6-21 SPRINGFIELD - _ 225 Fifth St ' = CITY OF SPRINGFIELD Springfield,OR 97477 �C Phone: 541-726-3753 OREGON Building I Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2013-01355 www.springfield-or.goy permitcenter©springfield-or.goy PROJECT STATUS: Issued ISSUED: 06/21/2013 EXPIRES: 12/17/2013 STATUS DATE: 06/21/2013 APPLIED: 06/21/2013 SITE ADDRESS: 3998 FRANKLIN BLVD,SPC#47,Eugene,OR 97403 SCOPE: Mechanical Only ASSESOR'S PARCEL NO: 1703344202400 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: New Furnace OWNER: CAMPBELL CARROLL GARY Phone Number: ADDRESS: 3998 FRANKLIN BLVD SPACE 47 EUGENE OR 97403 L CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone Mechanical Contractor DEAN M SHULTZ CCB 183169 08/09/2014 208-573-4714 INSPECTIONS REQUIRED Inspections 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 proper�, and,the approved set of plans will remain on the site at all times during ipruction. rye/ Owner or Contractor Signature Date ,7TICk: ATTENTION: Oregon law requires you to :HIS PERMIT SHALL EXPIRE IF THE WORK follow rules adopted by the Oregon Utility \UTHORIZED UNDER THIS PERMIT IS NOT Notification Center. Those rules are set forth COMMENCED OR IS ABANDONED FOR in OAR 952-001-0010 through OAR 952-001- 0090. You may obtain copies of the rules by ANY 180 DAY PERIOD. calling the center. (Note: the teleph:.e:-: number for the Oregon Utility Notification •• Center is 1-800-332-2344). • • • Springfield Building Permit 6/21/2013 1:41:48PM Page 1 of 1 SPRINGFIELD CITY OF SPRINGFIELD It '-t.1 a-. - 225 Fifth St `O EGON TRANSACTION RECEIPT Springfieid,OR 97477 541-726-3753 811-S P R2013-01355 www.springfield-orgov 3998 FRANKLIN BLVD. SPC 47 pennitcenter @springfield-or-gov RECEIPT NO: 2013001314 RECORD NO:811-SPR2013-01355 DATE:06/21/2013 LDESCRIPTION ,. __ACCOUNLCODE/TRANS CODE AMOUNT DUE_. First Appliance Fee 224-00000-425604 1006 80.00 State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 9.60 Technology fee(5%of permit total) • 100-00000-425605 2099 4.00 TOTAL DUE: 93.60 LPAYMENT�TYPE„ ,-_PAYOR' "cnsxtE R:ccaaeENrER �_� ;�COMMENTS � , � -. - '_ ..AMOUNT.PAID,� ' J -_ II Cash DEAN M SHULTZ 93.60 TOTAL PAID: 93.60 • Mechanical Permit Application DEPARTMENT USE ONLY ,1 - '"''r 'n'tG t�3�S'x-Sn;. 'x t tV; '7r't'Yn� i,-iMste a'?t SPRINGFIELD �-..� "-- El Z° 3 0(37 5- "CITSY O °SPRIN,,GEIEL , REG©Ne d Permit no.: 225 Fifth Street♦ Springfield,OR 97477 ♦ P1-1(541)726-3753 ♦ FAX(541)726-3689 , :a giff Date: (O_ 4(/ 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. .c ), CATEGORY?OF CONSTRUCTION, .,,. t 1 l,,, „ ,_?M , `FEE SCHEDULE,, , . _. .,.. � _. . , gab x ❑Residential ❑ Government ❑Commercial zResideMial i R fi}v x4 i - 2". ;Total %^. Furnace/burner i.Ja+g. .:mz Q�' $8 .0 .'$:cost *. ? :y'JOB'SITE INFORMATION•.rANDtILOCATION'7'rt-• pp ' 0.00 $ Job site address: /'i`2 /�/(� �}/fr �T includin ducts and vents City02/7L e/ State: O�� ZIP: Up to 100k BTU hr. $18.50 $ Over 100k BTU/hr. $22.00 $ Reference: Taxlot Heaters/stoves/vents 'k" ` "kDESCRIPT[DN,O ;W RIc , ;,:7: ' �G] /eG(R/� �( (v'�� , Unit heater Wood pelle gas stove/flue $18.50 $ $42.00 $ Repair/alter/add to heating appliance/ refrigeration unit or cooling system/ $80.00 $ �`.. i ) r.RkitRRORERTY.OWNNER g0;tif "'5 Ii'GS& 11, absorption system Name: �,L~i9-?, ('�AA! }-3�`/ Evaporated cooler $14.50 $ Address: �j / cD,�/l � f�� 7 Vent fan with one duct/appliance vent $70.00 $ City: ,4M/A25, Hood with exhaust and duct $14.50 $ ��//J� State: 0( ZIP: Floor furnace including vent $80.00 $ Phone5t( e�/��`�friFax: - - Gas piping g E-mail: /J '�" 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 $ .411iNtkiiP;CONTRACTOR INSTAL'LATIONix- {t;'?qµ t;'„` Compressor/absorption system/heat pump Business name ) Up to 3 hp/100k BTU $18.50 $ ?�� ��' / � z Up to 15 hp/500k BTU $32.00 $ Address:/ l >� Up to 30 hp/1,000 BTU $47.50 $ City: ' j e(( State:(/�C I ZIP:77t�(o_. Up to 50 hp/1,750 BTU $62.50 $ Phone - 7*62 Fax - -• Over 50 hp/1,750 BTU $104.50 $ E-mail: Incinerators �i./� f . Domestic incinerator $22.50 $ CCB license no.: CLj 1/1 / // FComme7cia Ki*it rtracay. `, } "" {�G�:, 1 fail Print name: / / L, U/ Enter total valuation of mechanical system Signature: / and installation costs$ Enter fee based on valuation of mechanical system,etc. $ j.t1iscellaineousfees *l�y{�1'eltems i Cost = Total '§ Reinspection $80.00 $ Specially requested inspections(per hr.) $80.00 $ ' Regulated equipment(unclassed) $14.50. $ Each additional inspection:(1) $80.00 $ "c '" s taigaitehiV ' (A)Enter subtotal of above fees(or enter set minimum fee of $80.00) $ (B)Investigative fee(equal to[A]) $ . (C)Enter 12%surcharge(.12 x[A+B]) $ (D)Seismic fee, 1%(.01 x[A]) $ (E)Technology Fee(5%of[A]) $ 440-2545-7(4/1/2013/COM) TOTAL fees and surcharges(A through E): $ 3±_:_- ,