HomeMy WebLinkAboutPermit Mechanical 2013-9-6 SPRINGFIELD 225 Fifth St
CITY OF SPRINGFIELD Springfield,OR 97477
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-,�` Phone: 541-726-3753
OREGON Building / Residential Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2013-02014
www.springfield-or.gov permitcenter @springfield-or.gov
PROJECT STATUS: Issued ISSUED: 09/06/2013 EXPIRES: 03/04/2014
STATUS DATE: 09/06/2013 APPLIED: 09/06/2013
. SITE ADDRESS: 7949 THURSTON RD,Springfield,OR 97478 SCOPE: Mechanical Only
ASSESOR'S PARCEL NO: 1702362000600 TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION: Woodstove
OWNER: JAGELS IAN J&MALEA A Phone Number:
ADDRESS: 7949 THURSTON RD
SPRINGFIELD OR 97478
L CONTRACTOR INFORMATION
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
Mechanical Contractor OWNER CCB 000000 05/01/2025
INSPECTIONS REQUIRED
Inspections
2140 Pellet, Gas, Fireplace or Wood Wood Stove: After Installation.
Stove
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.
Owner or Contractor Signature Date
!/
.O T N i?ON: Oregon law requires you to
NOTICE' buoy, 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 telephone
ANY 180 DAY PERIOD. number for the Oregon Utility Notification
Center is 1-800-332-2344).
Springfield Building Permit 9/6/2013 11:02:04AM Page 1 of 1
SPRINGFIELD • CITY OF SPRINGFIELD
4+ .a. 225 Fifth St
TRANSACTION RECEIPT Springtield,OR97477
541-726-3753
OREGON 811-SPR2013-02014
www.springfield-or.gov 7949 THURSTON RD pennitcenter @springfield-or.gov
RECEIPT NO: 2013001969 RECORD NO: 611-SPR2013-02014 DATE:09/06/2013
{DESCRIPTION - ,,ACCOUNT CODE/TRANSiCODELL AMOUNT.DUELI
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
AYMENT Tl(PE _.PAYOR CASHIER:CCARPENTER • COMMENTS . • H `" AMOUNT PAID
Credit Card JAGELS IAN J&MALEA A 93.60
TOTAL PAID: 93.60
•
Mechanical Permit Application • DEPARTMENT USE ONLY _s•
• ® RINGPTELD�®�27GO s E . z Permit no.: 3'_
• 225 Fifth Street• Springfield,OR 97477.• PH(541)726-3753 • FAX(541)726-3689 a7, ' Date: /6 /
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\,..../r..,,-...., ,
%Residential ❑Government ❑Commercial ;,Residential r ‘ Cost Total '
QtY -', a ;cst
JOB„SITE INFORMATION AND_LOCA�TIO�N First Appliance ( $80.00 $ �7j
Job site address:[[�� /it/`( /l,u )i-t I'1 20p1� �J Furnace/burner including ducts and vents
City:�(``no(,d d... State:o Q_ ZIP:C1./L.Q 0 Up to 100k BTU/hr. $18.50 $
_J Over 100k BTU/hr. $22.00 $
Reference: /20 2._ 56 2 J Taxlot O06&9 Heaters/stoves/vents
f); ''="[ DESCRIPTIONT'OF WORK? ,- ;: . , . Unit heater $18.50 $
I n Si &1.(1'NA) V' zui ci3Coct Sip/-Q-"I' venf Wood/pellet/gas stove/flue / $42.00 $
Repair/alter/add to heating appliance/
refrigeration unit or cooling system/ $80.00 $
-hs;M 7,41 PROPERTY*OWNER E' s ,* _° ' absorption system
Name: im .t. IM,yI w -Jc, Q �S Evaporated cooler $14.50 $
.,4 4 Cj L Jj Q Vent fan with one duct/appliance vent $10.00 $
Address: ors I D✓� i'�^Ot ---1 Hood with exhaust and duct $14.50 $
City: r f ack_ State:D� ZIP:AIL( `� Floor furnace including vent $80.00 $
Phonee6f 7* c�� Fax: Gas piping
E-mail: 1/y)es l k_14.0,1/4•2 cc@�vI�,I • C a r•� One to four outlets $7.50 $
This.installation is beig' made on p perry 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: Over 10,000 CFM $22.00 $
_*' )lC-ONTRACTORt INSTALLATION„ 33] _ i ` Compressor/absorption system/heat pump
Business name:C%YA/Ai✓ Uptto 3 hp/look 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.:
Comineitcial.'r 0 *c . �, .., ,„ t-.2._
Print name: Enter total valuation of mechanical system
and installation costs$
Signature: Enter fee based on valuation of mechanical system,etc. - $
emu c.�,�_ ..=sos t Total°°Misellaneous fees � Items ? e . ot,
;;.
Reinspection - $80.00 $
Specially requested inspections(per hr.) $80.00 $
Regulated equipment(unclassed) $14.50. $
Each additional inspection:(1) $80.00 $
v-n.. It A a !APPLICANVUSE , fir;
(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]) $ Cj
(D) Seismic fee, I%(.01 x[A]) $ /
(E)Technology Fee(5%of[Al) $ ( `='
440-2545-1(4/1/2013/COM) TOTAL fees and surcharges(A through E): $ ‘)?‘"°-