HomeMy WebLinkAboutPermit Mechanical 2013-6-28 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-SPR2013-01450 •
www.springfieldar.gov permitcenter @springfield-or.gov
PROJECT STATUS: Issued ISSUED: 06/28/2013 EXPIRES: 12/24/2013
STATUS DATE: 06/28/2013 APPLIED: 06/28/2013
SITE ADDRESS: 4082 S REDWOOD DR,Springfield,OR 97478 SCOPE: Mechanical Only
ASSESOR'S PARCEL NO: 1802061113900 TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION: Replace furnace.
OWNER: MEYER STEPHEN&KAREN P Phone Number:
ADDRESS: 4082 S REDWOOD DR
SPRINGFIELD OR 97478
CONTRACTOR INFORMATION
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
Mechanical Contractor HENDRIX HEATING&AIR CONDITIONING LTD CCB 95758 01/27/2015 541-753-6760
INSPECTIONS REQUIRED
Inspections
2300 Rough Mechanical Rough Mechanical: Prior to Cover
2999 Final Mechanical Final Mechanical: When all mechanical work is complete.
�. r•� �n law/ requires you to
By sign t and agree,that I have carefully examined the completed application arfdTdcEnNe1 Wclerci tRat all
H o "IQ regon Utility
informs to re s Cy r�����QQQrr t any and all work performedfsiinglbd8bf 6 ia�ee�'Crd hviird g are set forth
Ordinar �f�bf��Hl �.p or Oregon pertaining to thin,�rk¢te enb�d-'h�etin, 9'tRa�'N
l���r� l "` 'rat t1tmn� AR952.001-
OCCUPl ilp levR 'EIBauB�1? ItMu Ission of the Community Servic t i ®.�f$fll ft hrf9rihef the rules by
certify thatlov lyi¢gQ r®�14�r (ip' ��( �} pl'bmpliance with ORS 701.005 will jgppdy.�RititeayoritkiP Lfihk'?a ee •
to ensure that al�frqu Ons are requested at the proper time,that each address is a{9 e teleph:.:tiG
a efett>z erre Utility Notification
permit card is located t e front of�the property, and the approved set of plans will remain�I}�tSeff�l'dltlttrr(dg&'9(�
construction. Center is 1-800-332.2344).
Owner or Contractor Signature Date
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Springfield Building Permit 6/28/2013 8:18:00AM Page 1 of 1
SPRINGFIELD'--- CITY OF SPRINGFIELD
225 Fifth St
`OREGGN TRANSACTION RECEIPT Spnngfield.oR 97477
541-726-3753
• 811-SPR2013-01450
www.springfieldor.goy 4082 S REDWOOD DR permitcenter @spnngfield-or.gov
RECEIPT NO: 2013001376 RECORD NO:811-SPR2013-01450 DATE:06/28/2013
1s1 4y:Ird1P1∎(; ;t ta4 = 't7..w k.tiz h1 xi..'_,Lctit:- "ACCOUNT`CODElT- NS CODE 2JFLL 1 'AMOUNTDUE:t
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
P
PAYMEN—Nria - ,FAVOR c 1171471Ma COMMENTS AMOUNT{PAID
Credit Card HENDRIX HEATING&AIR 93.60
02560B CONDITIONING LTD
TOTAL PAID: 93.60
•
Mechanical Permit Application DEPARTMENT USE ONLY
SPRINGFIELD
4 CITY dF,Sk'RIl�(GFI Lb, QR GON i Permit no.: S2l(Zo(3(914E°
). ,,, .,.u_ ffi .iv., - n., nrwxr; _ , .,...rs r.•. `TSr 6....;
��Fifi11 Sired •Springfield,OR 97477 o Mt(541)726-3753 s FAX(541)7261689 1 k r .,.. eGON Date: 6 I" A')
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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 ISO days.
CATEGORY OF CONSTRUCTION FEE SCHEDULE
. Residential 1 ❑Government ❑Commercial Residential Qty. Cost Total
en. cost
JOB SITE iINFORMAT aN AND LOCATION First Appliance 500.00 Sg
Jab site address: I ' Fortune/burner including ducts and vents
City: l r1l � �om ZLP: & up to look BTUmr.
518.50 $
Over IOM BTU/hr. 522.00 $
Reference: Tax1nt.:
Heaters/stoves/vents
DESCRIPTI•N OF WORK Unit heater $18.50 S
ardi _4 1 / / r / Wood/pcllet/gas stove/flue $42.00 $
/)' t_o 7/1 1}, P . Repair/alter/add to healing appliance/
n ie�SJ C.Y) refrigeration unit or coaling s stenJ $80.00 $
PROPERTY OWNER absorption system
Nome: 11" J. _/ / Evaporated cooler $14.50 $
Address: �/��/�//�/}/!�%r 'r Vent fan with one duct/appliance vent 510.00 s
r�/�' ��,/"""'""�� I food with exhaust and duct $14.50 $
City: 0 Ada - State: �Larit��� Flour furnace including veal 580.00 $
Phone: UI 4 Cig70a Fox: Gas piping
E-mail: 1
One to four outlets $7.50 S
This installation is being made on property owned by me or a Additional outlets(each) $4.50 S
member of my immedialc family, and is exempt from licensing Alr-handling units,including ducts
requirements under ORS 701.010. Up to 10,000 CM 512.00 $
Signature: 1 Over 10.000 CFM $2200 , 5
CONTRACTOR INSTALLATION Compressor/absorption system/heat pump
Business name:-N? x 1, / t 11 L
Up to 3 npn 0ok BTU $18.50 $
Up to 15 hp/500k BTU $32.00 5
Address: i�I _'
.I v I !/�f//II • I. Up to 30 hp/1,0(10 BTU $47.50 S
City: 1 j 5 State: `T1 ZIP:n Up In 501m/1,750 BTU $6250 $
Phone: 4. / , tfrIMI Fax: I le11L Over 50 hp/1.750 BTU 5104,50 $
1 Incinerators
E-mail: r111�?rn'a @ 1,<e it rl ! �, . . .i
n Domestic incinerator I 522.50 I $
CCB license no.: ;"a. '{S ft-46z. Commercial
Print name: )�n6t, Enter total valuation of mechnnieal system
Signature: tenet s'rs, rr) i a ! and installation costs$
r 1r'/C//yll�i V.�/ Ll
Enter fee based on valuation of mechanical system.etc. S
' Miscellaneous fees Items Cost Total
en, cast
Reinspeclion $80.00 $
Specially requested inspections(per hr.) 580.00 S
Regulated equipment Outclassed) S14.50 5
Each additional inspection:(I) Sa0.00 $
APPLICANT USE
(A)enter subtotal of above fees(or enter set
minimum fee of 5 80.00) $
(B)Investigative fcc(equal to(Al) $
(C)Enter 12%surcharge(.12 x(A+B)) S q.lie
• 7 ID)Seismic fee. 1%(.01 x(A]) S
• (E)Technology Fee(5%of IA]) $
4411-15454 OM/20hJ/CO1It TOTAL fees and surcharges(A through C): a
Z/Z ELOZ-9Z-90 'aid OE:ZE:EO DIVV 6u14eaH sigma){ dogs LL