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HomeMy WebLinkAboutPermit Mechanical 2013-8-8 1. SPRINGFIELDa �..;� 225 Fifth St CITY OF SPRINGFIELD Springfield,OR 97477 lk Lax Phone: 541-726-3753 OREGON Building / Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2013-01773 www.springfieldor.gov perrnitcenter @spdngfield-or.gov PROJECT STATUS: Issued ISSUED: 08/08/2013 EXPIRES: 02/03/2014 STATUS DATE: 08/08/2013 APPLIED: 08/08/2013 SITE ADDRESS: 2267 MAIA LOOP,Springfield,OR 97477 SCOPE: Mechanical Only ASSESOR'S PARCEL NO: 1703251303100 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Heat pump OWNER: AMW LIVING TRUST Phone Number: ADDRESS: 2267 MAIA LOOP SPRINGFIELD OR 97477 CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone Mechanical Contractor APPLIED REFRIGERATION TECHNOLOGY INC GCB 133020 10/29/2014 541-830-5513 INSPECTIONS REQUIRED Inspections 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. Owne or Contractor Signature to `' • ATTENTION: Oregon law requires you to NOTICE: :, 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 90. You may obtain cough OAR 9527 rule 01- COMMENCED OR IS ABANDONED FOR 0090. You may obtain copies of the rules by ANY 180 DAY PERIOD. calling the center. (Note: the teleph:.: c • number Centeriss 1-800-332-2344)ification Springfield Building Permit 8/8/2013 11:48:55AM Page 1 of 1 • SPRINGFIELD--- CITY OF SPRINGFIELD 225 Fifth St TRANSACTION RECEIPT Spnngfield,OR 97477 OREGON 541-726-3753 811-SPR2013-01773 www.springfeld-ar.gov 2267 MAIA LOOP permitcenter spnngleld-ar.gov RECEIPT NO: 2013001727 RECORD NO:811-SPR2013-01773 DATE:08/08/2013 a41.a rtA.LI;a '.a.la Trke', "ACCOUNTICODEITRi4NSrCODE M;_` :AMOUNii-^DUET� 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 :-4 PAYMENT TYPE_..`-=PAYOR�-a casxiER:,ccnRPexrefeKt-a :COMMENTt �� 3^ Check APPLIED REFRIGERATION 93.60 2277 TECHNOLOGY INC TOTAL PAID: 93.60 Mechanical Permit Application DEPARTMENT USE ONLY �-�. tA SPRINGFIELD ! -7 `fi `%OF,SPR ELD,.OREG()N° - Permit no.: S1'7 — {77- v 225 Fifth Street ♦Springfield,OR 97477 ♦ P11041)7 6-3753 • FAX(541)726 3689 tiacGON Date: 7,77/ 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. CATEGORY OF CONSTRUCTION FEE SCHEDULE AResidential ❑Government ❑Commercial Residential Qty. Cost Total ea. cost JOB SITE INFORMATION AND LOCATION First Appliance ( S80.00 $ V , �7 A ja ' Furnace/burner including ducts and vents Job site address: ZZ(0 J 00� City: \ C(A dd State: Lt( ZIP: Up to 100k BTU/hr. $18.50 $ Reference: /3 Over 100k BTU:. $22.00 $ 7,05.25— Taxlot.: J3/ad Heaters/stoves/vents � DESCRIPTION OF WORK Unit heater $18.50 $ (,t� •^1ec p( um? Woodipellet/gas stove/flue $42.00 . $ 1 Repair/alter/add to heating appliance/ refrigeration unit or cooling system/ $80.00 $ PROPERTY OWNER absorption system Name: (N)t I I C S Evaporated cooler $14.50 $ Vent fan with one duct/appliance vent $10.00 $ Address: 501/4 (AA e Hood with exhaust and duct $14.50 $ City: I Sate: I ZIP: Floor furnace including vent $80.00 Phone:S4I -`iH(ft 5G,`O Fax: - - Gas pip ng , X1• y� � ) t (ur outlets $7.50 $ E-mail:mail: s. . l C - ] 7 1 ' ! a� V'_ �✓t �J Th installation is being made . property owned by me or a Additional outlets(each) $4.50 $ mem r of my immediate family, and is exempt from licensing Air-handling units,including ducts require ents under ORS 701.010. Up to 10.000 CPM $12.00 $ Signature: Over 10.000 CFM I $22.00 $ CONTRACTOR I STALLATION Compressor/absorption system/heat rump Business name: r 1 - �I t .1 tile : U $18.50 $b ot � I iQi94 ��iiirn� . b`� Up to IS p.!- l,,. $32.00 Address: ,,p Up to 30 hp!l.000 BTU $47.50 $ City: AA ((�� � State:.l LIP:9 [S0 k'Q(� / f 1 d � Up to 50 bpi 1;750 BTU $62.50 $ Phone:91 13� IQ33 Fax: - - Over 50 hp/1.750 BTU $104.50 I $ E-mail: Incinerators CCB license no.: (.3 3 D Domestic incinerator I ' $22.50 I $ Commercial Print name: D Enter ditotal valuation costs of mechanical system Signature: 11�"ff11/LLII and installation costs$_ ! Enter fee based on valuation of mechanical system.etc. S Miscellaneous fees items Cost ea. Total cost Reinspection . 580.00 $ Specially requested inspections(per hr.) $80.00 $ Regulated equipment(unclassed) $14.50 $ Each additional inspection:(l) $80.00 $ APPLICANT,USE (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]) $ -/ U (D)Seismic fee, I%(.01 x[A)) $ (E)Technology Fee(5%of[Al) $ 1--72-P- 440-2545-1(4/1/2013/COM) TOTAL fees and surcharges(A through E): $°27