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HomeMy WebLinkAboutPermit Mechanical 2013-9-26 SPRINGFIELD 225 Fifth St • CITY OF SPRINGFIELD Springfield,OR 97477 Phone: 541-726-3753 OREGON Building / Commercial Permit Inspection Phone:541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2013-02168 www.springfieldor.gov permitcenter @springfield-or.gov PROJECT STATUS: Issued ISSUED: 09/26/2013 EXPIRES: 03/25/2014 STATUS DATE: 09/26/2013 APPLIED: 09/26/2013 SITE ADDRESS: 6100 THURSTON RD,Springfield,OR 97478 SCOPE: Mechanical Only ASSESOR'S PARCEL NO: 1702342100400 TYPE OF STRUCTURE: Public PROJECT DESCRIPTION: Replace one boiler with three units,each<200KBTU OWNER: WILLAMALANE PARK 8 REC DIST Phone Number: ADDRESS: 250 S 32ND ST SPRINGFIELD OR 97478 CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone Plumbing Contractor MCKINSTRY CO LLC COB 172811 11/16/2014 503-331-0234 Mechanical Contractor MCKINSTRY CO LLC COB 172811 11/16/2014 503-331-0234 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. Owner or Contractor Signature Date ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth • in OAR 952-001-0010 through OAR 952-001- " NOTICE: 0090. You may obtain copies of the rules by THIS PERMIT SHALL EXPIRE IF THE WORK number for the,Oregon Utility Notification fi AUTHORIZED, UNDER THIS PERMIT IS NOT Center is 1-800-332-2344). COMMENCED OR IS ABANDONED FOR ANY 180 DAY PERIOD. • Springfield Building Permit 9/26/2013 9:35:20AM Page 1 of 1 • SPRINGFIELD CITY OF SPRINGFIELD 225 Frith St � EGON TRANSACTION RECEIPT Springfeld1OR97477 541-726-3753 811-SPR2013-02168 www.springfeld-or.gov 6100 THURSTON RD permitcenter©spdngfield-or.goy RECEIPT NO: 2013002144 RECORD NO:811-SPR2013-02168 DATE:09/26/2013 1o1*Yol [o]'t-f 3. =w +i '-F; _ '�, . t: Heir,F_sq-- -,§r". 'AGCOUNT'cODE/TRANs-CODE Y c:' NIOUNTDMZ Mechanical Permit fee(based on value of work) 224-00000-425604 1006 2,075.91 State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 249.11 Technology fee(5%of permit total) 100-00000-425605 2099 103.80 TOTAL DUE: 2,428.82 ,,..&.neri.,.�a� #54- �Px r :c r' AMOUNTPAID"�i ' ` _ xPAYAiIENT�TyPEs ����P,AY,OR�dASI+ieR:,ccnReeR7eR�1 tk�>m=„ COMIVIEN7S,-:`- - _�.s. , Credit Card Melisa Garwood 2,428.82 61114Z TOTAL PAID: 2,428.82 Mechanical Permit Application DEPARTMENT USE ONLY fi SPRINGFIELD CITY OF=SPRINGF[EL'Dy 4OREGON Permit no.: JI S — 2( 4 225 Fifth Street • Springfield,OR 97477• PH(541)726-3753 ♦F X(541)726-3689 6 h�O / 3 7 OREGON Date: 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 Co ❑Residential ❑Government ❑Commercial Residential Qty est Total a. cost JOB SITE INFORMATION AND LOCATION 1...Q First Appliance $80.00 $ ' Job site address: (al pU 77i LLA/P link. ,? Furnace/burner including ducts and vents Up to 100k BTU/hr. $18.50 $ r/ Citx./prb/br eft State: ZIP: hi-V-8 r (! Over 100k BTU/hr. $22:00 $ Reference: Taxlot.: Unit Heaters/stoves/vents DESCRIPTION OF WORK Unit heater $18.50 $ Ige/0/icr GQ CO 8oe I-e&. LA r-Fln-- S 4)z4A.3 Wood/pellet/gas stove/flue $42.00 $ IPA J Repair/alter/add to heating appliance/ refrigeration unit or cooling system/ $80.00 $ PROPERTY OWNER absorption system Name::C4 irgetweje aju�GJ 4 i c C Evaporated cooler $14.50 $ �/CZ -rG u..' try"..... /2 Vent fan with one duct/appliance vent $10.00 $ Address: Hood with exhaust and duct $14.50 $ Ci[ //„ /V vs et State: ZIP.��7 y/g Floor furnace including vent $80.00 $ Phon —7 -(!—400 G:, Fax: - - Gas piping _ E-mail:62a pyt_&H y e IAA II 4u tete-L v e 0/ One to four outlets $7.50 $ This installation is being made on property owned by me of a Additional outlets(each) $4.50 $ member of my immediate family, and is exempt from licensing Air-handling units, including ducts requirements tinder ORS 701.010_ Up to 10,000 CFM $12.00 S Signature: Over 10,000 CFM 522.00 S CONTRACTOR INSTALLATION Compressor/absorption system/heat pump • Business name: �//C 149.4-r1-7"1/4-1// , Co, Up to 3 hp/100k BTU $18.50 S ' Address: ? .1...� Up to I S hp/500k BTU $32.00 $ /O �! 0 �£ 0"/-� Up to 30 hp/1,000 BTU $47.50 S City: por-f-(a,Vt ot State: CQ Z1P:97020 Up to 50 hp/1,750 BTU $62.50 $ Phone::503 -'f o%. Sid 9- Fax5o3-331 (090 7-- Over 50 hp/1,750 BTU $104.50 $ E-mail:�tiCie-, 07 (I) AJGk%/Vr.f'1YV, co AA incinerators `/ / ��// Domestic incinerator $22.50 $ CCB license no.: Commercial Print name: in l c I t(,A,, (/Q.4 u e Z Enter total valuation of mechanical system U and installation costs$9O07 my Signa[urg: Enter fcc based on valuation of mechanical system,etc. $ Miscellaneous fees Items Cost Total ea. cost Reinspectioh $80.00 $ Specially requested inspections(per hr.) $80.00 $ Regulated equipment(unclassed) $14.50 $ Each additional inspection:(I) $80.00 $ • APPLICANT USE (A)Enter subtotal of above fees(or enter set minimum fee of $80.00) $26/-5-'y l/ (B)Investigative.fee(equal to[A]) $ (C)Enter 12%surcharge(.12 x[A+B]) $2ti (D)Seismic fee, l%(.01 x[A]) S . (E)Technology Fee(5%of[A]) $ /0?-Z(5)�7 -- l� 440-2545-J(4/1/2013/COm1) TOTAL fees and surcharges(A through E): $ 2 i • SPRINGFIELD 225 Fifth St CITY OF SPRINGFIELD Springfield,OR 97477 -(+�� Phone: 541-726-3753 ` OREGON Building / Commercial Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2013-02169 www.springfield-or.gov permitcenter @springfield-or.gov PROJECT STATUS: Issued ISSUED: 09/26/2013 EXPIRES: 03/25/2014 STATUS DATE: 09/26/2013 APPLIED: 09/26/2013 SITE ADDRESS: 6100 THURSTON RD,Springfield,OR 97478 • SCOPE: Plumbing Only ASSESOR'S PARCEL NO: 1702342100400 TYPE OF STRUCTURE: Public PROJECT DESCRIPTION: Backflow replacements for boilers OWNER: WILLAMALANE PARK&REC DIST Phone Number: ADDRESS: 250 S 32ND ST SPRINGFIELD OR 97478 CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone Plumbing Contractor MCKINSTRY CO LLC CCB 172811 11/16/2014 503-331-0234 Mechanical Contractor MCKINSTRY CO LLC CCB 172811 11/16/2014 503-331-0234 INSPECTIONS REQUIRED Inspections 3620 Backflow Device Backflow Device: Prior to covering and provide a copy of the test report on site at the time of inspection. 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. • _A• • Owner or Contractor Signature Date • ATTENTION: Oregon la the Oregon Util ty follow rules adopted by NOTICE: Notification Center. Those ruh OAF 952-001h THIS PERMIT SHALL EXPIRE IF THE WORK 0090.F 952may obtain copses of the rules by AUTHORIZED UNDER THIS PERMIT IS NOT calling the center. (Note: the telephone COMMENCED OR IS ABANDONED FOR number f ttehreisOrieloon_3U3t2ill 32 2 Notification •ANY 180 DAY PERIOD. Springfield Building Permit 9/26/2013 9:38:09AM Page 1 of 1 SPRINGFIELD CITY OF SPRINGFIELD r1 + ` 225 Fifth St ,� TRANSACTION RECEIPT Springfield,OR 97477 "�' �iiZ� 541-726-3753 OREGON 811-SPR2013-02169 www.springfieltl-ar.gov 6100 THURSTON RD permitcenter @springfieId-or.gav RECEIPT NO: 2013002145 RECORD NO:811-SPR2013-02169 DATE:09/26/2013 DESCRIPTION rc S irta s -:"ACCOUNTaCODE/TRANS'CODEO)_r "AMOUNT DUE. Backflow preventer 224-00000-425603 1005 21.00 Balance of Minimum Plumbing Permit Fees 224-00000-425603 1005 59.00 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 . BAXMENTarmE_ P.AYOR ,erR ccadrER EreamMENrc AMOUNT PAID Credit Card Melisa Garwood 93.60 61114z TOTAL PAID: 93.60 • Plumbing Permit Application DEPARTMENT USE ONLY , SPRINGFIELD CITY OF SPRINGFIELDMREGON ". _ • ._",:-) Permit no.: S,"? -21c$y 7/ // / / g 2b Fifth Street•Springfield,OR 97.177 • PH(541)726-3753 . FAX(54g726 3689 '� OREGON Date: 2'�P I This permit is issued under OAR 918-780-0060.Permits are issued only to the person or contractor doing the work. Permits I expire if worlds not started within 180 days of issuance or if work is suspended for 180 days. i LOCAL GOVERNMENT APPROVAL FEE SCHEDULE Zoning approval verified? ❑Yes ❑No Description Qty. Cost Total ea. cost Sanitation approval verified? ❑ Yes ❑No New residential , CATEGORY OF CONSTRUCTION I bathroom/1 kitchen(includes:first I 100 feet of hater/server lines.hose ❑Residential ( ❑Government I ❑Commercial bibs, ice nmker, underfloor(mr-point $262.00 $ JOB SITE INFORMATION AND LOCATION drains and rain-drain packages) i ,f 2 bathrooms/I kitchen $411.00 $.. ' Job site address:4 tao `T �,y,,,--yam- Red j Cit ffive /ci,p f State:/�J� Zt y7�j 3 Each additional kitchen thr $483.00 $ 3 VV /(J — • IT Each additional bathroom(over 3) $104.50 S 3 Reference: Taxlot.: Each additional kitchen(over I) $104.50 S I DESCRIPTION OF WORK Residential fire sprinklers(includes plan review) I i Qr4JA M ,j R/OE P %gn 0 to 2,000 square feet $80.00 $ 1 -/ }�_ �/Q (/- 2,001 to 3.600 square feet $128.00 $ j -l'P7ROPERTY/,OWNER 3,60 I to 7,200 square feet $192.00 $ 1 Name / ���--�g��pp /V � L� 7=201 square feet and greater $255.00 $ (r[ �/CO / A(,W 7d. Conuctionseob ildinggerera-fob(circle one) I Address: 'rh J Connections tobuildin sewer and I water supply $60.00 $ Cityfj:t., , ee clod_d_ State:6g ZIP9�ya I- It_ G? Commercial,industrial,and dwellings other than one-or Phone ]j-fl -�'OG�(.O Fax: - - two-family I E-mail: e &Y� � / Minimum fee _ $80.00 $ 33 QL/al tih 1 dia.,,.t? . o4U Each fixture $21.00 $ I This installation is being made on residential or farm property owned by me or a member of my immediate family,and is Miscellaneous fees exempt from licensing requirements under OAR 918-695-0020. 100'storm,sewer.water line $83.50 $ I I Ji Sigpature: Each fixture,appurtenance,and piping $21.00 $ 4 %% CONTRACTOR INSTALLATION Storm water retention/detention facility $21.00 $ ^Business name: AlGk,'n1-J en Irrigation systems /' $21.00 $ IL syPiping or private storm drainage €I! Address:Re 7-1 p . 4. „Afaocv, L# . stems exceeding the first 100 feet $21.00 $ Y ,-/o& c( ..�0 en o Specialty fixtures $21.00 $ Cit (� 'i-fa?. State: C.//t ZIP: Phoi e f a7 . 31 ) 4 I Faxs-c3-331- t0 10 Special requested sted of hrs.x fee per hr.) $80.00 $ 1 "' Special requested inspections(no.of $80.00 $ 1 E-mail: e/, r-, 0 e lej ns-I v✓,6/.( hrs.x fee per hr.) V / - Each additional inspection:(I) $80.00 $ 1 CCB license no.:/' d; / BCD license no.: 4 .it' Plumbing license no.: 33-— ',Da ' 3 Medical gas piping Minimum fee $ t Print name: /ntr f eta, ✓�r..( e__ Enter value of installation and equipment$_ I Enter fee based on installation and equipment value. $ 1 Signature: - APPLICANT USE (A) Enter subtotal of above fees ' i $ (Minimum Permit Fee$80.00) n 1 (B)Investigative fee(equal to[A]) $ 1 (C)Enter 12%surcharge(.12 x[A+111) $ 6°C) I (D)Technology Fee(5%of[A]) $ y/d!d f TOTAL fees and surcharges(A through D): $ 17 1 1 I i I I 440-2500-1(4/1/2013/COM)