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 `'
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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
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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