HomeMy WebLinkAboutPermit Mechanical 2013-7-12 ' SPRINGFIELD ° ° 225 Fifth St
CITY OF SPRINGFIELD Springfield,OR 97477
ho,
�o OREGON Phone: 541-726-3753
Building / Residential Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2013-01585
www.springfield-or.gov permitcenter@springfield-or.gov
•
•
PROJECT STATUS: Issued ISSUED: 07/12/2013 EXPIRES: 01/07/2014
STATUS DATE: 07/12/2013 APPLIED: 07/12/2013 .
SITE ADDRESS: 126 W OLYMPIC ST,Springfield,OR 97477 SCOPE: Mechanical Only
ASSESOR'S PARCEL NO: 1703274106700 TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION: revent existing ducts •
OWNER: HOUSING AUTHORITY&URBAN Phone Number:
ADDRESS: 300 W FAIRVIEW DR
SPRINGFIELD OR 97477
OWNER: RENEWAL AGENCY OF LANE CO Phone Number:
c
ADDRESS: 300 W FAIRVIEW DR •
SPRINGFIELD OR 97477
• CONTRACTOR INFORMATION
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
Mechanical Contractor PADDOCK MASONRY INC CCB 67081 06/18/2014 541-345-4629
•
INSPECTIONS REQUIRED b
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 property, and the approved set of plans will remain on the site at all times during
construction.
..„ =—�/� 7�i2�i
owner or Contractor Signa .–/ - Date
NOTICE: follow Oregon law requires you to
follow rules adopted by the Oregon Utility
THIS PERMIT SHALL EXPIRE IF THE WORK Notification Center. Those rules are set forth
AUTHORIZED UNDER THIS PERMIT IS NOT in OAR 952-001-0010 through OAR 952-001-
COMMENCED OR IS ABANDONED FOR 0090. You may obtain copies of the rules by
ANY 180 DAY PERIOD. calling the center. (Note: the telept..a-a
number for the Oregon Utility Notification
Center is 1-800-332-2344).
•
•
Springfield Building Permit 7/12/2013 9:10:41AM Page 1 of 1
SPRINGFIELD°• CITY OF SPRINGFIELD
225 Fifth St
h,;; TRANSACTION RECEIPT ngfeld,OR97477
OREGON 541-726-3753
811-SPR2013-01585
www.springfeldorgov 126 W OLYMPIC ST permitcenter@springfieid-or.gov
RECEIPT NO: 2013001515 _ RECORD NO:811-SPR2013-01585 DATE:07/12/2013
"ACCOGNTCODEITRANSLCODE - '!_. AMOUNT DUE
First Appliance Fee 224-00000-425604 1006 80.00
Single-duct exhaust(bathrooms,toilet compartments, utility room: 224-00000-425604 1006 30.00
State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 13.20
Technology fee(5%of permit total) 100-00000-425605 2099 5.50
TOTAL DUE: 128.70
-, PAYMENTIYPE PAY.OR eriii uRSON ,COMMENTS AMOUNT(PAID ,_
Cash PADDOCK MASONRY INC 128.70
684421
TOTAL PAID: 128.70
•
•
Mechanical Permit ApplicatioII r+.wn
DEPARTMENT{USE ON
LY
Y+s '' t c . swT*NVV � r 11 gcNI SPRINGFIELD
� CITYO SPRINGEIELD OREGON _ . _ Permit no.: [ ( O 5
S
°S alS-a$.4'Y" v'L �_^'+ .y+m .MLlYTtMr4 '[ d:.iA-�{ A-,f L: R y 1sci 225 Fifth Street♦ Springfield,OR 97477 • PH(541)726-3753 • FAX(541)726-3689 rY,? Date: ? //z //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.
,,, 7ATEORY, OFCONSt.RUCTION u t O-gx ,R, N .EE,SCHEDULE # s
k
• Cost Total
xesidential ❑Government ❑Commercial Residential z ` _ Qty =- I,r �''
. *,., ost °_
J9BfSITE INFORMATION;^AND (LOCATION s.i First Appliance $80.00 $
Job site address: 1 z6 (ci Of I�iGtzLie c L Furnace/burner including ducts and vents
City: l fl) State:V / ZIP: 7.2r7� Up to 100k BTU/hr. $18.50 $
f ,_ Over 100k BTU/hr. $22.00 $
Reference: Taxlot Heaters/stoves/vents
j; 3ra ° 'DESCRIIPTIO Wort.WOTRk's',gnx h4,r,�:), Unit heater $18.50 $
/'L-i. `7 ££ SI S n u y D ye-Ts Wood/pellet/gas stove/flue $42.00 $
• / Repair/alter/add to heating appliance/
refrigeration unit or cooling system/ $80.00 $
`ls t ,., „„+, ,PROPERTY+;OWNERrctt absorption system
Name: f1,/-cs, i.I Evaporated cooler $14.50 $
Address: .YQi,- / ' �J Vent fan with one duct/appliance vent 3 $10.00 $3 0
Hood with exhaust and duct 1 $14.50 $f r Co
City: S(f.� f J State: 0"— ZIP: ' Floor furnace including vent $80.00 $
Phone:ct(-1, 7 'tSapg Fax: - - Gas piping
E-mail: fvl 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 $
al<?, CON RAoOR INST LLA TON x t Compressor/absorption system/heat pump
Business name: rc�off)(yc.c Up to 3 hp/100k BTU $18.50 $
Zt7`� Up to 15 hp/500k BTU $32.00 $
Address: //°0 Up to 30 hp/1,000 BTU $47.50 $
City: � // State: 0;--- ZIP:')27(JZ- Up to 50 hp/1,750 BTU $62.50 $
Phone: -,''(f V' V/2.8T Fax: - - Over 50 hp/1,750 BTU $104.50 $
E-mail: Add 46-1C C9 C/c° fre Mg/
Incinerators
Domestic incinerator $22.50. $
CCB license no.: (;7 OF3/ ,,,, �s ei
rCORlfner,Ci81r`�.ts.�,a°; ra n,P't+-a..a �.x<-c:F st -^`a-��c?n,
Print name: 9/-7(640_,_/ €23.72 Enter total valuation of mechanical system
and installation costs$
Signature ,,, —�
Enter fee based on valuation of mechanical system,etc. $
ti 3< . v n°t s Items .tiCost Total>
Mist Ilan eous fees `y, i ;ea .-cost t„
Reinspection $80.00 $
Specially requested inspections(per hr.) $80.00 $
Regulated equipment(unclassed) $14.50. $
Each additional inspection:(1) $80.00 $
'�- r' -rAPPL'ICANTt, USE ang
(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-FB]) $
(D)Seismic fee, 1%(.01 x[A]) $
(E)Technology Fee(5%of[Al) $ .
440-2545-i(4/1/2013/COM) TOTAL fees and surcharges(A through E): $ /Zee 2a1--
•