HomeMy WebLinkAboutPermit Electrical 2013-8-21 SPRINGFIELD 225 Fifth St
CITY OF SPRINGFIELD Springfeld,OR 97477
OREGON
Phone: 541-726-3753
Building / Residential Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2013-01792
www.springfield-or.gov permitcenter @springfield-or.gov
PROJECT STATUS: Issued ISSUED: 08/21/2013 EXPIRES: 02/16/2014
STATUS DATE: 08/21/2013 APPLIED: 08/12/2013
SITE ADDRESS: 503 5TH ST,Springfield,OR 97477 SCOPE: Electrical Only
ASSESOR'S PARCEL NO: 1703352407400 - TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION: Bathroom•Fan
OWNER: HARLEY JOCELYN G Phone Number:
ADDRESS: 503 5TH ST
SPRINGFIELD OR 97477 •
OWNER: HULINGS KREG K Phone Number:
ADDRESS: 503 5TH ST
SPRINGFIELD OR 97477
L CONTRACTOR INFORMATION
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
General Contractor OWNER CCB 000000 08/01/2025
INSPECTIONS REQUIRED
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.
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ATTENTION: Oregon law requires you to • NOTICE'
follow rules adopted by the Oregon Utility
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 COMMENCED OR IS ABANDONED FOR
calling the center. (Note: the teleph.nlci
number for the Oregon Utility Ncllficat,on ANY 180 DAY PERIOD.
Center is 1-800-332-2344).
Springfield Building Permit 8/21/2013 1:23:42PM Page 1 of 1
SPRINGFIELD CITY OF SPRINGFIELD
.225 Fifth St
TRANSACTION RECEIPT Spnngfield,OR97477
OREGON 541-726-3753
811-SPR2013-01792
www.spnngfield-or.gov 503 5TH ST permitcenter @spnngfeld-or.gov
RECEIPT NO: 2013001826 RECORD NO:811-SPR2013.01792 DATE:08/21/2013
i -- - c. .O` ,. .�i�ez -.x•. _ �.,, * !t 'ACCOUNTiiCODE/TRANS CODE -- 3- IAMOUNTiDUE
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
ss`t hi s,r'�a cAsHIER a wRscii+t �' ;'t 'COMMENTS-.- ° A 0 liaallird.lifinj
Credit Card HULINGS KREG K 93.60
05427C
TOTAL PAID: 93.60
Mechanical Permit Application r DEPARTMENT_USE ONLY
'r�16'''ns, '- 'a '. l'L T .xa Sa,''i1c ' `a.marc.Ittir's ^ia.'2`n'Xgret ;PRINGFIaa.oi ... 1
Crtlfir OE PRINGFIELD4 OREG Permit no.: fa( 1749 13 o17 9 2.- 1
Date: !
225 Fifth Street• Springfield,OR 97477 • PH(541)726-3753 • FAX(541)726-3689 iTiA.1v r 8 I/
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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 180 days.
,. :,,f..r ,,,rcATEGORY'OF .CONSTRUCTJON q, ,A_'a,wi " F;:. ,<FEE SCHEDULE , 3 r.Fi?
Residential ❑Government ❑Commercial ..Reldentlal, 'tl k"„qR`{�"` ? IQtyz Cost#1tTotalL
zr' J,OB;SITE, INFORMATION: AND ;LOCATION;' q,/ First Appliance i $80.00 $
Job site address: 56 3 t, d1 Furnace/burner including ducts and vents
City ci e id State:CM ZIP: `j 71(7 7 Up to 100k BTU/hr. $18.50 $
Over 100k BTU/hr. I . $22.00 $
Reference: Taxlot Heaters/stoves/vents f
",�= ::24;, a': DESCRIPTION;,OF.tWO RK rQn,a,r ,, Y' Unit heater $18.50 $
Wood/pellet/gas stove/flue $42.00 $
Repair/alter/add to heating appliance/
refrigeration unit or cooling system/ $80.00 $
: ' k' 1 of . I ROPERTY. OWNERxr^*gtr-' r',-A"" absorption system
Name: 6!-1 OS Evaporated cooler $14.50 $
Address 3 5¢c ,S_
Vent fan with one duct/appliance vent $10.00 $
tc�� n Hood with exhaust and duct $14.50 $
City: �zq/7_.!>}, e(Qt/ State:Off ZIP: 74'77 Floor furnace including vent $80.00 $
Phone-'(-;rf-7-77- 3ste 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, and is exempt from licensing Air-handling units,including ducts
requirements der ORS 701.010. lip to 10,000 CFM $12.00 $
Signature: Over 10,000 CFM $22.00 $
r ..so Compressor/absorption system/heat pump
t4 ;hni,-__ ,' CT,O STALLATION4�'"
Business name:
Up to 3 hp/100k BTU $18.50 $
Up to 15 hp/500k BTU $32.00 $
Address: Up to 30 hp/1,000 BTU $47.50 $
City: State: ZIP: Up to 50 hp/1,750 BTU $62.50 $
Phone: - - Fax: - - Over 50 hp/1,750 BTU $104.50 $
E-mail: Incinerators .
Domestic incinerator $22.50 $
CCB license no.: ..
t.Commefcial"Wel ` 5*'SI ''i I i.
Print name: Enter total valuation of mechanical system
and installation costs$
Signature: Enter fee based on valuation of mechanical system,etc. - $
', ela ur T /asp ' ii$it yCost Tpta
�M-iscv neo �sfe°e.s_i7ea �, , R s .';ea
'.COSt,vaw
Reinspection $80.00. $
Specially requested inspections(per hr.) $80.00 $
Regulated equipment(unclassed) $14.50. $
Each additional inspection:(1) $80.00 $
-s, ," .it-* .? ARP„LIOANUL SErv- .F ? ' :, ..ViM. ,
,i •;(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]) $
(D) Seismic fee, I%(.01 x[A]) $
(E)Technology Fee(5%of[A]) $
..s 440-2545-1(4/1/2o13/COM) TOTAL fees and surcharges(A through E): $ ?.5 6 e2
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