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HomeMy WebLinkAboutPermit Mechanical 2013-6-26 SPRINGFIELD 225 Fifth St it` ' CITY OF SPRINGFIELD Springfeld,OR 97477 r` °O v Phone: 541-726-3753 OREGON N Building I Commercial Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2013-01406 www.springtield-or.gov permitcenter@springfield-or.gov PROJECT STATUS: Issued ISSUED: 06/26/2013 EXPIRES: 12/22/2013 STATUS DATE: 06/26/2013 APPLIED: 06/26/2013 SITE ADDRESS: 999 5 A ST,Springfield,OR 97477 SCOPE: Mechanical Only ASSESOR'S PARCEL NO: 1703354109200 TYPE OF STRUCTURE: Commercial PROJECT DESCRIPTION: Gas piping-5Lb pressure OWNER: R-H MCKENZIE COMPANY LLC Phone Number: ADDRESS: PO BOX 2280 EUGENE OR 97402 CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone Mechanical Contractor AMBASSADOR PIPING INC CCB 121469 03/27/2015 541-726-5723 INSPECTIONS REQUIRED Inspections 2255 Gas Pressure Test 2310 Rough Gas Rough Gas: After line is installed and required testing and capped if not attached to an appliance. 2995 Final Gas Final Gas: When all gas 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 o ,of the property, and the approved set of plans will remain on the site at all times during construction. Owner or Contra • Signature Date ATTENTION: Oregon law requires you to . follow rules adopted by the Oregon Utility NOTICE: "`' `' • Notification Center. Those rules are set forth THIS PERMIT SHALL EXPIRE IF THE WORK In OAR 952-001-0010 through OAR 952-001- AUTHORIZED UNDER THIS PERMIT IS NOT 0090. You may obtain copies of the rules by 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 6/26/2013 2:37:28PM Page 1 of 1 • SPRINGFIELD CITY OF SPRINGFIELD :1 C `O EGON TRANSACTION RECEIPT 225 Fifth R Springfiel dOR97477 541-726-3753 811-S PR2013-01406 www.springfield-or.gov 999 S A ST pennitcenter @springfield-or.gov RECEIPT NO: 2013001357 RECORD NO: 811-SPR2013-01406 DATE:06/26/2013 DESCRIPTION __w` "_ACCOUNT.CODE/TRANSC.ODE__ _AMOUNTDUEY. Mechanical Permit fee(based on value of work) 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 - CASHIER:CCARPERiER . . COMMENTS - • -' AMOUNT PAID _ - Credit Card Charles Coury 93.60 045063 TOTAL PAID: 93.60 • Mechanical Permit Application DEPARTMENT,USE ONLY -c-- .y W' P ` �Witi h¢:nry� SPRINGFIELD .2'm+cw (�•1WM.keE1 �1' SPRINGEIELY3D:FORE i = ` ». . Permit no.: S�3 -- '&i ., ..,> `�- an.�,._.,$t..Ememr aw..aa:G,�trcm' - x. 'aa e - �225 Fifth Street♦ Springfield,OR 97477 ♦ PH(541)726-3753 ♦ FAX(541)726-3689 ,2tiet,, Date: 0724//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. =( CATEGORYr OAICONSTRUCTION , , ` i tFEE CSCHEDULE;} a` 1R: srde nia i 3 Mn a Q' ? Ceoa t ..;eTcoota_l c❑Residential ❑Government Commercial JOB;;SITE INFORMATION'"AN_D (LOCATION r- First Appliance $80.00 $ Job site address: qgq 3 ep.,41'1 4 - rider`' Furnace/burner including ducts and vents City 4bYiy V,e1A I State: fl ZIP g74/7� Up tol00kBTUhr. $18.50 $ _ [ Over 100k BTU/hr. $22.00 $. Reference /76,-j �S'eirt Taxlot D22_0a Heaters/stoves/vents .:*-1,---,'DESCRIPTION;]OFD WORK;;t r „K-�, ;'.. Unit heater $18.50 $ A,q'' zired c(745 Wpr 0/.3+4/l Wood/pellet/gas stove/flue $42.00 $ Repair/alter/add to heating appliance/ refrigeration unit or cooling system/ $80.00 $ ` '' _ t, ;PROPERTYt'OWNER {ii'?„ `4 rl"i'`__ -: absorption system Name: —4- A( Ye n7/e rar71 0flV / /-c Evaporated cooler • $14.50 $ Address: �� 2 Z 1 Vent fan with one duct/appliance vent $10.00 $ . Hood with exhaust and duct $14.50 $ City: Cu oh (L e State: a ZIP:9-Noe Floor furnace including vent $80.00 $ Phone: -J - 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,/ d is exempt from licensing Air-handling units, including ducts requirements under ORS 7!1.1 re Up to 10,000 CFM $12.00 $ r Signature:7,..d....1 r Over 10,000 CFM $22.00 $ F*-l=`" ` cdbNTRACT4 4INSTALLATIOe�,1M Compressor/absorption system/heat pump Business name: 4, 665 p1 . e 0C M -Avl Up to 3 hp/look BTU $18.50 $ 1 Up to 15 hp/500k BTU $32.00 $ Address: Ao ye 7o -3 2 Up to 30 hp/1,000 BTU $47.50 $ City: ,/°�L/) State: � ZIP: �y7S Up to 50 hp/1,750 BTU $62.50 $ Phone: 72.-c 72 3 Fax: - - Over 50 hp/1,750 BTU $104.50 $ E-mail: Incinerators Domestic incinerator $22.50 $ CCB license no.: 7/ tic C� ,../ x,:Commercial°.y'��i�"��,�`�"�.,)'FS'(iFa `&-rrta`,, .. .,`?>;N,` Print name: Enter total valuation of meth nical system and installation costs$ /9 00 Signature: Enter fee based on valuation of mechanical system,etc. . $ TO tt <Mtscellafeo e . vgen Prig `p + neous feesr 1 ;Items -;Cost Total Reinspection $80.00 $ Specially requested inspections(per hr.) $80.00 $ Regulated equipment(unclassed) $14.50. $ Each additional inspection:(I) $80.00 $ r:4111 ` 'APIPLICANT SE 1 aK, ri (A)Enter subtotal of above fees(or enter set J minimum fee of $80.00) $ 20 (B)Investigative fee(equal to[A]) $ (C)Enter 12%surcharge(.12 x[A+B]) $ q4,0. (D)Seismic fee, 1%(.01 x [A]) $ (E)Technology Fee(5%of[A]) $ (/00 440-2545-J(4/1/2013/COM) TOTAL fees and surcharges(A through E): $ c/ 36 •