HomeMy WebLinkAboutPermit Mechanical 2013-8-21 •
SPRINGFIELD 225 Fifth St
CITY OF SPRINGFIELD Springfield,OR 97477
.,i Phone: 541-726-3753
OREGON Building / Residential Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2013-01872
www.springfieldor.gov permitcenter @springfield-or.gov
PROJECT STATUS: Issued ISSUED: 08/21/2013 EXPIRES: 02/16/2014
STATUS DATE: 08/21/2013 APPLIED: 08/21/2013
SITE ADDRESS: 1249 PARKER ST,Springfield,OR 97477 SCOPE: Heating System
ASSESOR'S PARCEL NO: 1703264416600 TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION: Relocate furnace
OWNER: BAILEY BARBARA L Phone Number:
ADDRESS: 4226 SCOTTDALE ST
EUGENE OR 97404 •
CONTRACTOR INFORMATION
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
Mechanical Contractor CHITTIM ENTERPRISES I INC CCB 47396 03/24/2015 541-461-2101
• INSPECTIONS REQUIRED
Inspections
2300 Rough Mechanical Rough Mechanical: Prior to Cover
2999 Final Mechanical Final Mechanical: Wien 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. �J /
Owner or Contra to ignature Date
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Springfield Building Permit 8/21/2013 11:22:25AM Page 1 of 1
SPRINGFIELD - -- CITY OF SPRINGFIELD
�� -urv•.; ,,, 225 Fifth St
� TRANSACTION RECEIPT Spnngfield,OR 97477
tr„L� 541-726-3753
' OREGON
811-SPR201 3-01 87 2
www.spdngflem-or.gov 1249 PARKER ST permitcenter @spnngfield-ar.gov
RECEIPT NO: 2013001819 RECORD NO:811-SPR2013-01872 DATE:08/21/2013
DESCRIPTIO arE2 aW t q�u"_ k a`x",_> a .. NCo 0 4;RANS!CODE SS42 `AMOUNT DUES'
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•
"PAYMENTSTYPE Ir.PAYOR t&SHIER:OBO WSBY Sieill&COMMENTS .'; .*".4 .r ' !y i PAID 'W:ni
Credit Card BAILEY BARBARA L 93.60
012809
TOTAL PAID: 93.60
Mechanical Permit Application -.N:.-DEPARTmENtusE oNLY::- ,:,
'.7c,I.,„i:e‘i.,„;:favogilfuwsysiti!nivai:eiwk,:tmimiti,4;:etpqm SPRINGFIELD -7,
Penn it no.: Z
41,1€4,11EYAOESPRINGFIELDaiREPONGa a ale40, re:PI
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225 Fifth Street• Springfield,OR 97477 • PH(541)726-3753 • FAX(541)726-3689 w',,,,,..-'4- * -* r/ / -2
Date: di a i /1 ...7
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.
tkitboksOoKttitittfiCid))01■g.:,Oniti:::::,}. RitiCiittszagg ,:Acticppc.
--;:-.**"-s- . — ..-'-'"r--- ,,-;.,...-:-1:m, irLin•Sii.,,w .. ,_,,- ;.:-..€.,cfc?c,-;,-,,__3 ,,,cogc., .,T6tal,7:..
/Residential [' Government 0 Commercial :II;$ !?..;VIII:Ii”igNNYie4.2''';:/iVI:::!..IIY.,.. 1::46:arT.,: il.,:,,,;;;;Eiist
.. clibb siTE:IN rtlikhilktitm,:fASD.LOCATION 4,:i.A ,L First Appliance $80.00 $
Job site address: I &1-t9 po , ,„ 54- Furnace/burner including ducts and vents
Up to 100k BTU/hr. $18.50 $
City: 5ce ptio State:04 ZIP:q)97.7
O 100k BTU/hr.
Reference: I 70-c Z...‘ C( jyypRisc:::,ssw
V Taxlot.: /1600 ver
Heaters/stoves/vents $22.00 $
::,;',:Pn.7‘9:#,:9:;;A:SESCRIPTiONktfi.•..-rwr ',V.-.'
Unit heater $18.50 $
rrActuti 40\1\052--) — a-broatr Wood/pellet/gas stove/flue $42.00 $
Repair/alter/add to heating appliance/
refrigeration unit or cooling system/ $80.00 $
tngioaVtipM,14§PROPERTYroWNEFkeri%q.tf*iWS4 absorption system
Name:
Evaporated cooler $14.50 $
Gov,,,lcencto, P),..,s,Fsej
Address: c/c.„3‘.. Scol-Id _
Vent fan with one duct/appliance vent $10.00 $
} o,RsL riN
Hood with exhaust and duct $14.50 $
City: Q.,./Avn.a., Stath:Ot._ ZIP:9>efori
Floor furnace including vent $80.00 $
Phone: ç-2-y1 - 607--5-5-S-7 Fax: - - Gas piping
E-mail: IrN...._.bo,,k„..i. e va.koo•cnr One to four outlets $7.50 $
This installation is being Inade 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: ,4Øj_ , - < Over 10,000 CFM $22.00 $
YarActi N\ 74016.dr§;TALTI5Affit , .1,,fi.f,,,,11,:4,F,fil:,T,,, z Compressor/absorption system/heat pump
Up to 3 hp/100k BTU $18.50 $
Business name: ary.,,,a0 .-310,,:1---)14-e) -
Up to 15 hp/500k BTU $32.00 $
Address: //6— /nAkm..,,,-4a... 5-
Up to 30 hp/1,000 BTU $47.50 $
City: <4 ...tAr...A. State: c.-C. ZIP: rw-0,,,I, Up to 50 hp/1,750 BTU $62.50 $
Phone: 7—7116— 9-y Le Fax: - - Over 50 hp/1,750 BTU $104.50 $
E-mail: , Incinerators
Domestic incinerator I $22.50 $
CCB license no.: 4'73 g-‘?"
:106111-17T61.:4- lalRgraletPAA:4":t2PI -71en
Print name: Enter total valuation of mechanical system
and installation costs$
Signature:
Enter fee based on valuation of mechanical system,etc. $
tEr;:raernyttxt-wra..t:Fcaffm,vm;;;;:,mticitg.g,4lIc9.:tf,L -77,9-ffic2.:
:V4-1 I Saql1/4,94.1,a9 V.seNU2 1:;ts'n- kl'oL-lb-
Dt it;ii..triea:i.iitIa INITCost S3
Reinspection . $80.00 $
Specially requested inspections(per hr.) $80.00 $
Regulated equipment(unclassed) $14.50. $
Each additional inspection:(1) $80.00 $
atweamarAsittaggisceriNti
(A)Enter subtotal ees(or enter set
minimum fee 80.00) $ 15 CD
(B)Investiga fee(equal to[A]) $
(C)Enter 12%surcharge(.12 x[A+B]) $ 7
- (D)Seismic fee, 1%(.01 x[A]) $
(E)Technology Fee(5%of[A]) $
440-25454(4/1/2013/COM) TOTAL fees and surcharges(A through E): $73 60