HomeMy WebLinkAboutPermit Mechanical 2013-10-8 •
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SPRINGFIELD - 225 Fifth St
CITY OF SPRINGFIELD Springfield,OR 97477
Phone: 541-726-3753
OREGON Building / Residential Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2013-02241
www.springfeld-or.gov permitcenter@springfield-or.gav
PROJECT STATUS: Issued ISSUED: 10/08/2013 EXPIRES: 04/06/2014
STATUS DATE: 10/08/2013 APPLIED: 10/08/2013
SITE ADDRESS: 589 HARLOW RD A,Springfield,OR 97477 SCOPE: Mechanical Only
ASSESOR'S PARCEL NO: 1703271200900 TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION: ME-HVAC
OWNER: STOLSIG CHARLES A JR&MICHELLE C Phone Number:
ADDRESS: 589 HARLOW RD#A
SPRINGFIELDAR 97477
CONTRACTOR INFORMATION
Contractor Type Contractor Name Lic Type Lic No. Lic Exp Phone
Mechanical Contractor ASSOCIATED HEATING 8 AIR CONDITIONING INC CCB 106275 08/31/2014 541-683-2590
Mechanical Contractor BLUE STAR GAS ASSOCIATES CO CCB 179266 12/03/2013 707-573-3130
INSPECTIONS REQUIRED
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Inspections
2300 Rough Mechanical . Rough Mechanical: Prior to Cover
2310 Rough Gas Rough Gas: After line is installed and required testing and capped if not attached to
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an appliance.
2995 Final Gas Final Gas: When all gas work is complete.
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
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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. (1.(Sky I�0�0� �R� 1��9Y1�y Io1B7).3
Owner or Contractor Signature Date
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ATTENTION: Oregon law requires you to
follow rules adopted by the Oregon Utility NOTICE:
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).
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Springfield Building Permit 10/8/2013 8:21:36AM Page 1 of 1
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, SPRINGFIELD CITY OF SPRINGFIELD
225 Fifth St
{ ,� TRANSACTION RECEIPT Springfield,OR 97477
*S. 541-726-3753
OREGON 811-SPR2013-02241
www.springfield-or.gov 589 HARLOW RD A - permitcenter @springfleld-or.gov
RECEIPT NO: 2013002226 RECORD NO:811 SPR2013-02241 DATE: 10/08/2013
D P O _`s. er ` a gr' + : x �� ACCOUNT • e RANS CODE e *_=AMOUNTDUEiS
Air Handling Unit up to 10,000 cfm 224-00000-425604 1006 18.50
First Appliance Fee 224-00000-425604 1006 80.00
LP Gas Tank and Piping 224-00000-425604 1006 18.50
Range hood/other kitchen equipment 224-00000-425604 1006 14.50
Single-duct exhaust(bathrooms,toilet compartments, utility room: 224-00000-425604 1006 30.00
State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 20.58
Technology fee(5%of permit total) 100-00000-425605 2099 8.58
Vent for appliance other than furnace 224-00000-425604 1006 10.00
TOTAL DUE: 200.66
P.AYMENTATYPE`. iP,AVOR ...-cas nER:,JLARSDN ' COMMENTS AMQUNTILIAID,F M„
Check STOLSIG CHARLES A JR&MICHELL 200.66
592
TOTAL PAID: 200.66
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,Mechanical Permit Application DEPARTMENT USE ONLY
C± .rw.i' aa ..M.. Sactx+umt st.W-me e
iITT OF SPR `IIELDj OREGU a ° Permt no.: S'l I zJ
I.-5 022.4 l
225 Fifth Street • Springfield,OR 97477 • P11(541)726-3753 • FAX(541)726-3689 N
OREGON Date: /o /g / / "5
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 Total
TTT" ea. cost
JOB SITE INFORMATION AND LOCATION First Appliance / $80.00 $
Job site address: 53 D �
A- Mltle,3 - Furnace/burner including ducts and vents
c Up l0 00 BTU/hr.r. $18.5D $
City ��, State: Of ZI P:q�"q�� Over IOOk $22.00 $
Reference: Taxlot.:
Heaters/stoves/vents
DESCRIPTION OF WORK Unit heater 518.50 $
I4 VAL Wood/pellet/gas stove/Iluc $42.00 S
Repair/alter/add to heating appliance/
relrigcration unit or cooling system/ $80.00 S
PROPERTY OWNER absorption system
I��� a Evaporated cooler $14.50 S
Name: - (11 A $ E I J I e, 3, V h p �y
t Vent Can ry J id]one duel/appliance vent $10.00 S
Address: »y 1k • .
-,„” Bond with exhaust and duel $14.50 S
City'' • 0 Stator—I ZIP:a tr-t1-Y Floor furnace including vent $80.00 S
Phone: 4t 466- yj' 94 f. Fax: - IAA- Gas piping
E-mail: N A • One to four outlets I $7.50 $
This installation is being made on property owned by me or a Additional outlets(each) $4.50 S
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 i $12.00 S
Signature: Over 10.000 CF61 $22.00 $
CONTRACTOR INSTALLATION Compressor/absorption system/heat pump _
Up to 3 hp/100k 11W / $18.50 $
Business name:
�� e,i.Jt p✓�L Up to 15 hp/1,00 FEW $32.00 $
Address: Owl Up to 30 hp/1,000 B'I'l1 $47.50 S
City: State: ZIP: Up to 50 hp/1,750 FIT() $62.50 $
Phone: - - Fax: - - Over 50 hp/I.750 BTU — $104.50 $
F.-mail: Incinerators
Domestic incinerator 1 $22.50 $
CCB license no.: i 0(0 2.75 Commercial
Print name: Filter total valuation of mechanical system
and installation costs$
Signature;
Enter fee based on valuation of mechanical system.etc. S
Miscellaneous fees Items cost "ford
ea. east
Reinspection $80.00 $
Specially requested inspections(per hr.) $80.00 .$
Regulated equipntent(unelnssed) $14.50 $
Each additional inspection:(I) 580.00 S
APPLICANT USE
. (A)Enter subtotal of above fees(or enter set
minimum fee of $80_00) $
()I) Investigative fee(equal to[Al) $
(C)Enter 12%surcharge(.12 x[r1+B]) $
(D)Seismic fee. I%(.01 x (A]) S
(E)Technology Fee(5%of[A]) $
440-2545-1(4/1/2013/COM) TOTAL fees and surcharges(A through E): $760 42-6_