HomeMy WebLinkAboutPermit Mechanical 2013-9-9 SPRINGFIELD 225 Fifth St
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CITY OF SPRINGFIELD Springfield,OR 97477
cc� Phone: 541-726-3753
OREGON
Building / Residential Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2013-02025
www.springfield-ar.gov permitcenter @springfield-or.gov
PROJECT STATUS: Issued ISSUED: 09/09/2013 EXPIRES: 03/07/2014
STATUS DATE: 09/09/2013 APPLIED: 09/09/2013
SITE ADDRESS: 389 SCOTTS GLEN DR,Springfield,OR 97477 SCOPE: Mechanical Only .
ASSESOR'S PARCEL NO: 1703271309800 TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION: Replace heat pump
OWNER: NESTER ROBERT PATRICK Phone Number: .
ADDRESS: 389 SCOTTS GLEN DR .
SPRINGFIELD OR 97476
CONTRACTOR INFORMATION I
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
Mechanical Contractor CHRISTOPHER DANIEL STEWARD CCB 199906 05/20/2015 541-525-7214
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 roperty, and the approved set of plans will remain on the site at all times during
construction. /
ci
9/9/C3 .
Owner or Contractor Signature Date
ATTENTION: Oregon law requires you to
follow rules adopted by the Oregon Utility
Notification Center. Those rules ar 9 2 001-
In OAR 952-001
0 090. You may obtain copses of the rules by
0090.
calling the center. (Note: the telephone j`:
number for the Oregon Utility Notification PERMIT SHALL EXPIRE IF THE WORK .
• Center is 1-800-332-2344).
, ':'ORIZED UNDER THIS PERMIT IS NOT
•
lliNENCED OR IS ABANDONED FOR
SQ DAY PERIOD.
Springfield Building Permit 9/9/2013 9:52:27AM Page 1 of 1
SPRINGFIELD CITY OF SPRINGFIELD
225 Fifth St
at TRANSACTION RECEIPT Springfield,OR97477
OREGON 541-726-3753
811-SPR2013-02025
www.springfield-or.gov 389 SCOTTS GLEN DR permitcenter@springfield-or.gov
RECEIPT NO: 2013001984 RECORD NO:811-SPR2013-02025 DATE:09/09/2013
DESCRIPTION _ __. _ACCOUNT-CODE/TRANSCODE r;'AMOUNT_DUE _!
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
[,_PAYMENT_TYPE_,,,.� PAYOR_ CASHIER:ccARPENlER�` COMMENTS_ - .t • _ ` AMOUNT PAID ..
Check CHRISTOPHER DANIEL STEWARD 93.60
01-0181
TOTAL PAID: 93.60
•
Mechanical Permit Application DEPARTMENT:USE ONLY ;.
L'tilitYg OFD SPRINGEIELIWREGON A t Permit no.: ,S'7 3 — 2 S
Tl,-„3 . _., +ter.§... ,..?kfi'!n m:i4,:2wu ,Z4z.rra-nL:.. ;�a.h:".t wt..a r..„3 a.,, /'
225 Fifth Street♦ Springfield,OR 97477 • PH(541)726-3753 • FAX(54I)726 3689 -.J='�.+... Date: 9�J // 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 ` :: : .. 1" F,EE SCHEDULE gn k
)(Residential ❑ Government ❑ Commercial Residential u�' ' kn`°Y' Qty f ';east osfl
/ i!JQB SITE INFORMATIONAND LOCATION'" .,3. . First Appliance / $80.00 $8-0
Job site address: 3 gq S66 1/::, 610-7 Furnace/burner including ducts and vents
City: 5PIPD State: p it zIP:97y7/ Up to 100k BTU/hr. $18.50 $
Over 100k BTU/hr. $22.00 $
Reference: /70:1_ , , / Taxm lot . 7
Heaters/stoves/vents
a; r 4 4DECRIP O E WORK , y.. 3-ii . ley
Unit heater $18.50 $
P----a-T/04 44-1 Y Wood/pellet/gas stove/flue $42.00 $
Repair/alter/add to heating appliance/
refrigeration unit or cooling system/ $80.00 $
jrsf S is a+7,t1PROPERTY'OWNER 5 - s ss. , ,x,�Xw,`A absorption system .
Name: j3 c-fey' Evaporated cooler $14.50 $
Address: 3Ql-'f _ � t) :� Vent fan with one duct/appliance vent $10.00 $
�/^ Hood with exhaust and duct - $14.50 $
City: /v r� Stag' 7 ZIP:Q-Ary Floor furnace including vent $80.00 $
PhonerP(([-9/3 b0P- 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 under ORS 701.010. Up to 10,000 CFM Z $12.00 $
Signature: Over 10,000 CFM $22.00 $
- ,tr CONTRACTORINSTALLATION = F rv,4w;_ Compressor/absorption system/heat pump
Business name: No wAvg- I l C�//H)- Up to 3 hp/100k BTU $18.50 $
s Up to 15 hp/500k BTU $32.00 $
Address: I(I(A. y ?
City:�4 State: or d ZIP: 17y77 Up to 50 hp/1,7750 BTU $62.50 $
Phone: `j'q( 5)4- 72/r! Fax: - - Over 50 hp/1,750 BTU $104.50 $
E-mail: P]ogd d2cp/ e (/.o, zQ5t', He`(— Incinerators
�� !� "CDomestic incinerator $22.50 $
CCB license no.: --
o merc m Commercial <-+fs.?' +'WJ: . s ,...e .< „ -ir ,.:i
Print name: /47l-1 ru� f tc p yO . Enter total valuation of mechanical system G� $e
�7 and installation costs$
Signature: — Enter fee based on valuation of mechanical system,etc. $
t=`' - t Cost 'Total z
Miscellaneous fees p, }r , items „tea cost :".
Reinspection $80.00 $
Specially requested inspections(per hr.) $80.00 $
Regulated equipment(unclassed) $14.50. $
Each additional inspection:(I) $80.00 $
;,, 0 - 4.1.','APPLICANT USE : #5.R i,A!s',y'
(A)Enter subtotal of above fees(or enter set c oy0
minimum fee of $80.00) $
(B)Investigative fee(equal to[A]) $
(C)Enter 12%surcharge(.12 x[A+B]) $ 9 e,-Q---
(D)Seismic fee, 1%(.01 x[A]) $
(E)Technology Fee(5%of[A]) $ t{
440-2545-3(4/1/2013/COM) TOTAL fees and surcharges(A through E): $ qT�t--