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Permit Mechanical 2013-10-29
SPRINGFIELD 225 Fifth St CITY OF SPRINGFIELD Springfield,OR 97477 Nt Phone: 541-726-3753 OREGON Building / Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2013-02407 . www.Springfield-or.goy perm itcenter @springfiel d-or.gov PROJECT STATUS: Issued ISSUED: 10/29/2013 EXPIRES: 04/27/2014 STATUS DATE: 10/29/2013 APPLIED: 10/29/2013 SITE ADDRESS: 233 9TH ST,Springfield,OR 97477 SCOPE: Mechanical Only ASSESOR'S PARCEL NO: 1703354200800 TYPE OF STRUCTURE: Residential • PROJECT DESCRIPTION: MEC-Move exterior bathroom wall out 18 inches-requires historic review. OWNER: CHAFFIN-BRITT LORI Phone Number: ADDRESS: 233 N 9TH ST . SPRINGFIELD OR 97477 L CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lic No • Lic Exp Phone Mechanical Contractor J LOGUE GAS WORKS INC CCB 147111 03/05/2015 541-345-7599 General Contractor TONY VICTOR DENN CCB 153447 11/13/2014 541-954-4012 • INSPECTIONS REQUIRED II Inspections 2140 Pellet, Gas, Fireplace or Wood Wood Stove: After Installation. Stove . 2250 Gas Piping 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 an appliance. 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 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 constructfi(on,.',{ O 'on,2 the W:It 0.‘1114 to AT'� noted _.,Ades at -001• /C i9'-I ' 1)Jt 1 \1tv rUl^.r,- - a3 VI wn1 0att ctoo�•`gnaturea9 s O'the 1U1; n Date .,;,_.-. 9621' 01 ve;n oople e telePr�r , • tQ�gp�Voum ae ber. l�lotUtid<Y +.�otii;catic wDP'K E n �mbec jOf the OCi app-332 234��, ,,ICYCIC : VNU-t- 91Etwo, SNOT �entet ;s M,1j DER 1H�S FOR ZN;S PERZED UN 1S ABANDONED mUTIi0EN0Ela 0R SOD• co' pER ANY 180 D AV • Springfield Building Permit 10/29/201 9:32:21AM Page 1 of 1 SPRINGFIELD CITY OF SPRINGFIELD t1 .9aa.- 225 Fifth St :\( TRANSACTION RECEIPT Springfield.OR97977 OREGON 541-726-3753 811-S P R2013-02407 www.springfield-or.gov 233 9TH ST perrnitcenter©springfield-or.gov RECEIPT NO: 2013002376 RECORD NO: 811-SPR2013-02407 DATE: 10/29/2013 (DESCRIPTION ACCOUNT CODEITRANS_CODE,, V ._.AMOUNT DUE First Appliance Fee 224-00000-425604 1006 80.00 Flue vent for water heater or gas fireplace 224-00000-425604 1006 10.00 Gas Piping up to 4 outlets 224-00000-425604 1006 7.50 State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 11.70 Technology fee(5%of permit total) 100-00000-425605 2099 4.88 TOTAL DUE: 114.08•_. :PAYMENT TYPE' PAYOR _=CASHIER:DeOWLSBY -:;;: COMMENTS: ->- :AMOUNT PAID a. Check J LOGUE GAS WORKS INC m 114.08 5537 TOTAL PAID: 114.08 Mechanical Permit Application DEPARTMENT USE ONLY SARINGI. """ - O 2 O 7 GIT_Y O ,r GF?Iit' :Dy,d .LGt:)N .. Permit no.: S/ 225 Fifth Street •Springfield,OR 97477 4 P[I(541)7263753 • FAX(54I)7263589 ' \OR EGO N Date: /V 2 / /.3`. 1. } 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 I ❑Government ❑Commercial Residential Qty. Cost Total ea. cost JOB SITE INFORMATION AND LOCATION First Appliance $80.00 $ Job site address: 3 2 3 Z c - Furnace/burner including ducts and vents 'p City: .c cA State:O( . ZIP: Up to 100k BTU/hr. $18.50 $ S)° �p� Over 100k BTU/hr. $22.00 $ Reference: 1 7033 SYJZ Taxiotee BOO - Unit Heaters/stoyes/vents DESCRIPTION OF WORK Unit heater $18.50 $ 1✓ls '1 tAS `P\`f'p •1-O 41F1'r^t K L£SS Wood/pellet/gas stove/flue $42.00 $ I t 1},t Q. .f("�,� Repair/alter/add to heating appliance/ V"`f� x✓"'�' f t C‘^—C.-L.. l✓t S�' refrigeration unit or cooling system; $80.00 $ 'PROPERTY OWNER absorption system Name: ,o •1 rtN�` Evaporated cooler $14.50 $ �. • Vent fan with one duct/appliance vent $10.00 $ F Address: c/ev✓l Hood with exhaust and duct $14.50 $ City: State: ZIP: Floor furnace including vent $80.00 S Phone: ;y.— 7z% 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 $12.00 $ Signature: Over 10.000 CFM - $22.00 $ CONTRACTOR INSTALLATION Compressor/absorption system/heat pump Business name: 3' J(7�eKS Up to 3 hp/look BTU $18.50 $ L 0G.LPL 6, C ^' Up to 15 hp/500k BTU $32.00 $ W‘Address: 'B � Up to 30 hp/1.000 BTU I $47.50 $ City: go C ,.�-L StateQ' • ZI fq X-v2 Up to 50 hp/1.750 BTU $62.50 I $ Phone: 5E41 - 5"---751Y' Fax: - - Over 50 hp/1,750 BM $104.50 I S E-mail: Incinerators 171 Domestic incinerator $22.50 $ CCB license no.: CO,�s Commercial Print name: Z.:bur2 [9 Lt: Enter total valuation of mechanical system / and installation costs$ Signature: �l 7 Enter fee based on valuation of mechanical system,etc. S Miscellaneous fees Items east costs Reinspection 580.00 $ 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 / 7= minimum fee of$80_00) $ (B)Investigative fee(equal to[A]) $ (C)Enter 12%surcharge(.12 x[A+B]) $ If (D)Seismic fee, I%(.01 x[A]) $ (E)Technology Fee(5%of[A]) $ 440-2545-1(4/12013/COMI TOTAL fees and surcharges(A through E): $ ,! /