HomeMy WebLinkAboutPermit Mechanical 2013-10-8 •
SPRINGFIELD 225 Fifth St
t CITY OF SPRINGFIELD Springfield,OR 97477
- i Phone: 541-726-3753
OREGON Building / Residential Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2013-02249
www.springfeld-or.gov permitcenter @springfield-ar.gav •
PROJECT STATUS: Issued ISSUED: 10/08/2013 EXPIRES: 04/06/2014
STATUS DATE: 10/08/2013 APPLIED: 10/08/2013
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SITE ADDRESS: 1016 3RD PL,Springfield,OR 97477 SCOPE: Mechanical Only
ASSESOR'S PARCEL NO: 1703352105401 TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION: DHP
OWNER: SWEARINGEN LAURA L Phone Number:
ADDRESS: 1016 3RD PL
•
SPRINGFIELD OR 97477 •
CONTRACTOR INFORMATION
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
NEIL KELLY CO (C)Electrical Cent C984 07/01/2014 503-28&7461
INSPECTIONS REQUIRED
II
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 re•uired inspections are requested at the proper time, that each address is readable from the street, that the
permit card is I• ated at th- ront of the property, and the approved set of plans will remain on the site at all times during
construction.
. 107/(A/73____
Owner or Contractor re Dat
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NOTICE: ATTENTION: Oregon law requires you to
THIS PERMIT SHALL EXPIRE IF THE WORK follow rules adopted by the Oregon Utility
AUTHORIZED UNDER THIS PERMIT IS NOT Notification Center: Those rules are set forth
;OMMENCED OR IS ABANDONED FOR in OAR 952-001-0010 through OAR 952-001-
0090. You may obtain copies of the rules by
NY 180 DAY PERIOD. calling the center. (Note: the telephone
number for the Oregon Utility Notification
. Center is 1-800-332-2344).
Springfield Building-Permit 10/8/2013 10:34:42AM Page 1 of 1
SPRINGFIELD, OF SPRINGFIELD
03/44 225 Fifth St
`" R'E�oa TRANSACTION RECEIPT Springfield,OR97477
541-726-3753
811-SPR2013-02249
www.springfeldor.gov 1016 3RD PL permitcenter @springfield-or.gov
RECEIPT NO: 2013002233 RECORD NO: 811-SPR2013-02249 DATE: 10/08/2013
DESCRIPTIONS"` �-�.t .ate _ `' teACCOUNTaCODEISRANSTCODE ,,;_. 'AMOUNT'Dl1E.Y
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
WITEW ERY—rest: ` P.AYOR caraR Virok;` -. ,.' arilaOMMENTSgr " _, - 4M9,11 N 13LITRigraitA
Credit Card NEIL KELLY CO 93.60
04529Z
TOTAL PAID: 93.60
Mechanical Permit Application DEPARTMENT USE ONLY
_ $PRi' -
' Permitno.: ' l 17-ot3 022 (
CITY O./ SPRINGFIELD,QREGO1No
sme �-...-. a i u'-.fass+.om.�� ..*+e..Ni'-. -ry IEL•aa..r �t
225 Fifth Street • Springfield,OR 97477 • P48540726-3753 * FAtUapP_C,(89 y{ �i
•s OREGON Date: (o 78 A -j
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 clays.
CATEGORY OF CONSTRUCTION FEE SCHEDULE
V Residential ❑Government ❑Commercial Residential Qty. Cost ea. Total
cost
JOB SITE INFORMATION AND LOCATION First Appliance / $80.00 $
Job site address: h I if 3r e d Mace Furnace/burner including ducts and vents
—
City: --�_ State: _ GIP: ��(� �-_ Up to I(IOk B'I'Ulhr. `..,,- $18.50
Over 100k BTU/hr, $22.00
Reference: Taxlot.:
Heaters/stoves/vents
DESCRIPTION OF WORK Unit heater $18.50 $
al die cs f+" Wood/pellet/gas stove/flue $42.00 S
Repair/alter/add to heating appliance/
refrigeration unit or cooling system/ $80.00 $
PROPERTY OWNER absorption system
Name: _ SJJ_w t Evaporated cooler $14.50 $
Vent Ian with one ding duetiancc vent $10.00 S
Address: V -
I-loud Wilh exhaust❑nd duet $14.50 S
City: 52 Slate: ZIP: Floor furnace including vent 580.00 5
Phone 41- - 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) $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 / I- $12.00 I $
. Signature: Over 10.000 CFk1 I $22.00 S
CONTRACTOR INSTALLATION Compressor/absorption system/heat pump
r r � Up to 3 hpil GOk BTU U $18.50 .$
Business name: N .i\ -Cl W, -........ _...._. — ..--
D� Up to l5 hp/500k BTU $32.00 $
Address: T Oa,P.
O��i, Upm30 hp/1.000 BTU S47.50 .$
City: L / r State if . ZI1 .Qsce<�l up to 50111)/1,750 Bill 562.50 $
Phon ati -�j cols) Fax: - - Over 50 hp/1.750 BTU 5104.50 $
E-mail: ,--) Incinerators
- �-� Domestic incinerator 522.50 $
CCB license no
1\ ,, ( QOL , Commercial
Print name: _ 5 NV O _ y�ylc!-.-._-.-_.__ Enter total valuation of mechanical system
and installation costs$
Signature:
Enter fee bused on valuation of mechanical system.etc. $
Miscellaneous fees Items Cost Total
ea. cost
Reinspection $80.00 $
Specially requested inspections(per hr.) 580.00 S
Regulated equipment tunclassed) $14.50 $
Each additional inspection: (I) $80.00 S ---
APPLICANT USE
(Al Enter subtotal of above fees(or enter set
minimum lee of $80.00) $
(B)Investigative fee(equal to[A]) $
(C)Enter 12%surcharge(.12 x[A+B]) $
(0)Seismic fee. I%(.01 x [A]) S
(E)Technology Fee(5%of IAJ) $
440.25454(4/I/2013/COnq TOTAL fees and surcharges(A through E): $9 3-