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Home My WebLink AboutPermit Mechanical 2013-9-17 SPRINGFIELD - • 225 Fifth St CITY OF SPRINGFIELD Springfield,OR 97477 E` l Phone: 541-726-3753 OREGON Building / Residential Permit Inspection Phone: 541-726-3769 • Fax: 541-726-3676 PERMIT NO: 811-SPR2013-02086 www.springfieldor.gov permitcenter @springfeld-or.gov PROJECT STATUS: Issued ISSUED: 09/17/2013 EXPIRES: 03/16/2014 STATUS DATE: 09/17/2013 APPLIED: 09/17/2013 • SITE ADDRESS: 2449 15TH ST,Springfield,OR 97477 SCOPE: Mechanical Only ASSESOR'S PARCEL NO: 1703243301700 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Heat Pump Install OWNER: EMIL R KLYM TRUST Phone Number: ADDRESS: 2449 15TH ST SPRINGFIELD OR 97477 OWNER: RITA M KLYM TRUST Phone Number: ADDRESS: 2449 15TH ST SPRINGFIELD OR 97477 • CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone • Mechanical Contractor KENT WITHAM AIR INC CCB 189283 01/20/2014 541-543-6580 _ 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. AIL _�/ ✓ � 9-�7� � Owner or Co tractor Signature Date • 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 OAR 952-001-0010 through OAR 952-001- • COMMENCED OR IS ABANDONED FOR 0090. You may obtain copies of the rules by Calling the center. (Note: the telephone • ,, r'wer_aln;t number for the Oregon Utility Notification Center is 1-800-332-2344). • r • Springfield Building Permit 9/17/2013 9:19:52AM Page 1 of 1 SPRINGFIELD • CITY OF SPRINGFIELD 225 Fifth St ;, Cei TRANSACTION RECEIPT Springfield,OR 97477 541-726-3753 OREGON 811-SPR2013-02086 www.springfield-or.gov 2449 15TH ST permitcenter@springfield-or.gav RECEIPT NO: 2013002045 RECORD NO:811-SPR2013-02086 DATE:09/17/2013 ACC OUNTrGODEILRAN3 CODE':""= .ter -•`AMOUNT-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 7'..P -TYPE ,`, :PAYOR+- CASHIER JLARSON.,_.._- COMMENTS ..c, _ ,� '! -.AMOUNTTPAID Trat-krys; Check KENT WITHAM AIR INC 93.60 2330 TOTAL PAID: 93.60 • • Mechanical Permit Application DEPARTMENT USE ONLY SPRINGFIELD �1 Q USING! �ELM it—01 is m Permit no.:6/7 & / 19 Z � ( to. z� 225 Huh Suva ♦ Springfield,OR 97477 ♦ P11(541)726-3753 ♦ IAN(:41)726-3689 ''t2.O NE00N Date: Vie 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. CATEGORY OF CONSTRUCTION FEE SCHEDULE -Residential ❑Government ❑Commercial Residential Qty. Cost coil JOB SITE INFORMATION AND LOCATION First Appliance / $80.00 $ 'fA Furnace/burner including ducts and vents Job siteaddress/(:��yy9 � [ ',� $ --- City: her H5ciet a State: OR ZIP: /71477 Up to )OOk B'I'U/hr, $18.50 _ Over look B1'U/hr, $22.00 Reference: Taxtot.: Heaters/stoves/yen Is DESCRIPTION OF WORK f_ Unit heater $18.50 $ XW5� Fora'Fp- d Arr. f{ecck-Pokt, 5yafert, Wood/pellet/gas stove/flue $42.00 S Repair/alter/add to heating appliance/ refrigeration unit or cooling system/ $80.00 S PROPERTY OWNER absorption system'1 Name: .KLykYl R; -A Evaporated cooler $14.50 S Address: d'49 9 /5 1-5 S I Vent fan with one duct/appliance vent $10.00 S Hood with exhaust and duct $14.50 S City: Sprihccreia State:OQ /_w:97417 7 Floor furnace including vent $80.00 S Phone: - - Fix: - - Gas piping E-mail: One to lour outlets $7.50 $ This installation is being made on property owned by me or a Additional outlets(each) S4.50 $ member of my immediate family, and is exempt from licensing Air-handling writs, including ducts requirements under ORS 701.010. Up to 10.000 C'FM $12.00 S Signature: Over 10.000 GEM $22.00 S CONTRACTOR INSTALLATION Compressor/absorption system/heatpjpjp pp Up to 3 hp/100k BTU $18.50 $ Business name: �jQtn4- G.5i40 4 A. r TIAC ------ --------- Box 175 Up to lS hp!SOOI: BTU 532.00 Address: n0 ess: / Up to 30 hp/I.000 BTU 547.50 S City: S Pr inj field state:OR ZIP: ?72/77 Up to 50 hp/1,750 Mil 552.50 S Phone:5 a3 -6580 FaxM/-656-2/926 Over 50 ht/1,75o BTU $104.50 $ E-mail: S)9q�p gofhcail aCql�/ — Incinerates 57 d0 3 • Domestic ineiucrmor $22.50 $ CCB license no.: /�' - -- L Commercial Print name: �e{1'I / f Enter total valuation of mechanical system and installation costs$ Signature: / Enter lee based on valuation of mechanical system.etc. $/ • Miscellaneous fees Items Cost Total ea. cost Rcinspeetion $80,00 $ Specially requested inspections(per bra $80.00 S Regulated equipment Outclassed) $14.50 $ Each additional inspection:(I) $80.00 S 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 o surcharge(.12 x[A+Bp $ (D)Seismic fee. 1%(.01 x [A]) $ (E)Technology Fee(5%of[A]) $ 440-2545-1(4/1/2013/COM) TOTAL fees and surcharges(A through E): $r Z O