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HomeMy WebLinkAboutPermit Mechanical 2013-10-14 • SPRINGFIELD - 225 Fifth St CITY OF SPRINGFIELD Springfield,OR 97477 (ar- Phone: 541-726-3753 Building / Commercial Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2013-02294 wvnv.springfeld-or.gov • permitcenter @springfield-or.gov • PROJECT STATUS: Issued ISSUED: 10/14/2013 EXPIRES: 04/12/2014 • STATUS DATE: 10/14/2013 APPLIED: 10/14/2013 SITE ADDRESS: 2000 NUGGET WAY, Eugene,OR 97403 SCOPE: Mechanical Only ASSESOR'S PARCEL NO: 1803031101100 TYPE OF STRUCTURE: Commercial PROJECT DESCRIPTION: Refrig. Unit OWNER: UNITED STATES BAKERY Phone Number: ADDRESS: 2000 NUGGET WAY EUGENE OR 97403 • CONTRACTOR INFORMATION Y Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone Mechanical Contractor AMERICAN REFRIGERATION INC COB 112736 04/10/2015 541-688-0939 INSPECTIONS REQUIRED II 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 contruction. • -/5- /3 • Owner or Contractor Signature Date • 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- 0090. You may obtain copies of the rules by AUTHORIZED UNDER THIS PERMIT IS NOT calling the center. (Note: the telephone COMMENCED OR IS ABANDONED FOR number for the Oregon Utility•Notification - ANY 180 DAY PERIOD. Center is 1-800-332-2344). • Springfield Building Permit 10/14/201 9:52:35AM Page 1 of 1 • • SPRINGFIELD -- CITY OF SPRINGFIELD ' 225 Fifth St y� TRANSACTION RECEIPT Spnngfield,OR 97477 ' 541-726-3753 0"''' O OREGON 811-SPR2013-02294 www.springfield-or.gov 2000 NUGGET WAY pennitcenter©spnngfield-or.gov RECEIPT NO: 2013002273 RECORD NO:811-SPR2013-02294 DATE: 10/14/2013 ç - . ' :k .. k �_•� _. _ 3_R 2::1-ACCOUNT.CODE/TRANSICODE ,:`tlf AMOUNTIolr14 Mechanical Permit fee(based on value of work) 224-00000-425604 1006 90.33 State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 10.84 Technology fee(5%of permit total) 100-00000-425605 2099 4.52 TOTAL DUE: 105.69 °,'FAYMENT E PAYOR... nsweat.'LARSaN COMNIENTS- �c QMQUNT�F_A,IUD_ Credit Card AMERICAN REFRIGERATION INC 105.69 000016 TOTAL PAID: 105.69 • • Mechanical Permit Application DEPARTMENT USE ONLY SPRINGFIELD ---- - CITY,OESPRINGHELD O GO.N" Permit no.: Bf r Zc9/3 0zzcz E( t,- .., - - ,�ray 225 Fifth Street • Springfield,OR 97477 • PIip41)726 3753 • FA'((54I)726-3(,R9 tt -. OdEGON Date: l0// 1/// -3 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 l otnl en. cost JOB SITE INFORMATION AND LOCATION First Appliance $80.00 $ Job site address: :70-60 /014.97014-0-/A1 Furnace/burner including duets and vents / Up to 100k BTU!hr. $18.50 S City: 907", State: cc ZIP: 911yl3 Over 100k BTU/hr. $22.00 S Reference: Taxlot.: Heaters/stoves/vents DESCRIPTION OF WORK Unit heater $18.50 $ )Ac-/_4( AP Pp Tns.' 114P Wood/pellet/gnu stove/flue $42.00 $ -- Repaidalter/add to heating appliance/ ' refrigeration unit or cooling system/ $80.00 S PROPERTY OWNER absorption system Natne: J am- /7 /�- Evaporated cooler $14.50 S / G__ /_/SGL Vent fan with one duct/appliance vent $10.00 S Address: l7D-e7 A11�f/� Flood with exhaust and duct $14.50 S City: z`_ Stale:w— ZIP. 17Y3 —_ Floor furnace ineludma vent $00.00 S Pho V -a-21( Fax - - Gas piping _ E-mail: One to four outlets 1 $7.50 S 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. tip to 10.000 CM $12.00 S Signature: Over 10.000 CFNI $22.00 $ CONTRACTOR INSTALLATION Compressor/absorption system/heat puny Up to 3 hp/100k BTU $18.50 $ Business r J unic: , +r-ra re` ___-_..__............... Up 10 15 hp/5001:BTU $32.00 $ Address: 575 5( ___,_ Up to 30 hp/1.00(1 BTU $47.50 $ City: f Stale: O ZIP: 7754P--. Up to 50 hp/1.750 BTU $62.50 S Phone: S� -4J o?3T Fax: - - Over 50 hp/1.750 13rU $104.50 $ E-mail: n Incinerators �e _keQ2rtr 9ew`. Domestic incinerator $22.50 I $ CCB license no.: la -73� o Commercial Print name: !0 Li E(- Enter total valuation of mechanical system and lash(lotion costs$ Signature: • �,�. — _ Enter lee based on valuation of mechanical system.etc. 5 Miscellaneous fees Items cost Total ea. cost Rcinspection $80.00 $ Specially requested inspections(per hr.) $80.00 S Regulated equipment(uttelassed) $14.50 $ Each additional inspection: (I) $80.00 S APPLICANT USE VU Enter subtotal of above fees(or enter set minimum fee of $80.00) $ (B)Investigative fee(equal to[A]) $ (C)Enter 12%surcharge(.12 x[A+B1) $ (D)Seismic fee. 1%(.01 x [Al) S (E)Technology Fee(5%of[A]) $ 440-2545-J(-1/1/2013/COM) • TOTAL fees and surcharges(A through E): $/dC6y-