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Home My WebLink AboutPermit Mechanical 2013-9-25 SPRINGFIELD _. �: 225 Fifth St 1 },a CITY OF SPRINGFIELD Springfield,OR97477 t„ .+ 'k Phone: 541-726-3753 OREGON Building / Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2013-02158 www.springfield-or.gov permitcenter @spnngfield-or.gov PROJECT STATUS: Issued ISSUED: 09/25/2013 EXPIRES: 03/24/2014 STATUS DATE: 09/25/2013 APPLIED: 09/25/2013 SITE ADDRESS: 245 19TH ST,Springfield,OR 97477 SCOPE: Wood Stove/Insert ASSESOR'S PARCEL NO: 1703364201500 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Wood stove OWNER: NIGH RONNI R Phone Number ADDRESS: 245 19TH ST SPRINGFIELD OR 97477 CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone Mechanical Contractor JACC ENTERPRISES INC CCB 162960 01/28/2015 541-747-8600 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. r rr`-,1 LL. c j,A _ °( /ZS' l 13 Owner or Contractor Signature Date ATTENTION: Oregon law requires you to. NOTICE' 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 number for the Oregon.Utility Notification ANY 180 DAY PERIOD. Center is 1-800-332-2344). • Springfield Building Permit 9/25/2013 11:22:24AM Page 1 of I SPRINGFIELD CITY OF SPRINGFIELD ' r 225 Fifth St TRANSACTION RECEIPT Sp-- ringfield,OR 97477 OREGON 541-726-3753 811-SPR2013-02158 www.springfieldor.gov 245 19TH ST permitcenter @springfield-ar.gov RECEIPT NO: 2013002134 RECORD NO: 811-SPR2013-02158 DATE:09/25/2013 ) I.� IA111lrf40rrkm emu,`` n+ r` ickr. Is-;FIL2:gACCOUNTPCODETRANSCODE ! =1 4;i,t M fifIUC1 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 PAYMENTM P.�x�-RATa ialr ;cc�`'Ziir Ewa,. r , COMMENTS r . ?HMO Ti PAID; f. Check NIGH RONNI R 93.60 1083 TOTAL PAID: 93.60 • Mechanical Permit Application DEPARTMENT USE ONLY y [ .-. v -cb N.-tr sw s-arn c y✓k' w SPRINGFIELD �NCTY OFSERIGFIELDOREGON . permit no.: S S �'7 225 Filth Street • Spnnelield.OR 97477 • PIR5411726-3153 • FAX(541)726-3689 6",YS`O EGON Date: / 2 /1 This permit is issued under OAR 918-440-0050. Permits expire if work is not started within 180 clays of issuance or if work is suspended for 180 days. CATEGORY OF CONSTRUCTION FEE SCHEDULE Residential ❑Government ❑Commercial Residential Qty. Cost Total ea. C JOB SITE INFORMATION AND LOCATION First Appliance ( $80.00 $ Job site address: LC-I Cj IU q'-� Furnace/burner including ducts and vents City: )L� State:cl ZI q ` i Up to 100k BTWhr. $18.50 $ �� / Over IOOk f3"fU!hr. $22.00 $ Reference: TaxIot.: Heaters/stoves/vents I DESCRIPTION OF WORK �? Unit heater $18.50 S L,1.��t.�.N `,1s L,t .- (�OOC,( �, [ i /`1 Wood/pellet/gas stove/flue 7- $42.00 S at lyd �J\ Repair/alter/add to heating appliance/ refrigeration unit or cooling system/ $80.00 S PROPERTY N OWNER absorption system ame: li �i , Evaporated cooler $14.50 S Address: y t age-) I� S Vent fan with one duct/appliance vent $10.00 S Hood with exhaust and duel $14.50 S City:Sh&LCI $tate:O(L ZIPT7 q7 7 Floor furnace includine vent $80.00 S PhoncL ' oi (3 qq 3Ne.„ Fax: - - Gas piping __ E-mail: One to four outlets $7.50 S This installation is being made on property owned by me or a Additional outlets(each) 54.50 S Member of my,' imediate family, and is exempt from licensing Air-handling units, including ducts requirements un LE l r ORS 701.010.1 C C 1.010. Up to 10.000 CFM $12.00 $ v� l Signature: G I� Over 10.000 CFM $22.00 S CONTRACTOR INS ALLATION Compressor/absorption system/heat pump I 2 S — Dr, Up m3 hp/100kBU $18.50 $ Business name.-j'�/l -C.� Up to 15 hp/500k BTU $32.00 $ Address: Up to 3(111p/1.001) 0.1U 547.50 5 City: • State: ZIP: Up to 50 hp/1,750 BTU $62.50 S Phone:5(4 ( 7 34, Up Zd Fax: - - Over 50 hp/1.750 BTU $104.50 $ E-mail: Incinerators -- j ^' Domestic incinerator 522.50 CCU license no.:�(/1n "/7 Commercial - — Print name: Enter total valuation of mechanical system and installation costs$ Signature: Enter lee based on valuation of rnecl antcal system.etc. $ Miscellaneous fees Items Cost lord ea. cost Reinspection $80.00 $ Specially requested inspections(per hr.) $80.00 S Regulated equipment tunclassed) $14.50 $ Each additional inspection: (I) $80.00 S APPLICANT USE (A)Enter subtotal of above fees(or cater set yadO minimum fee of$80_00) $ (B)Investigative fee(equal to[AI) S (C)Enter 12%surcharge(.12 x [A+B]) ---... SGT G • (D)Seismic fee. 1%(-01 x [A]) $ (E)Technology Fee(5%of[A]) $ Vu-- 4d0-2545-J(4/Un113/COM) TOTAL fees and surcharges(A through L): $ ��j7� •