HomeMy WebLinkAboutPermit Mechanical 2013-11-21 SPRINGFIELD • 225 Fifth St
SPRINGFIELD
CITY OF SPRINGFIELD Springfield,OR 97477
t, 4,( �s Phone: 541-726-3753
= OREGON Building I Commercial Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR201 3-01 850 •
www.springfield-or.gov permitcenter@springfield-or.gov
PROJECT STATUS: Issued ISSUED: 11/21/2013 EXPIRES: 05/20/2014
STATUS DATE: 11/21/2013 APPLIED: 08/19/2013
SITE ADDRESS: 5880 MAIN ST,Springfield,OR 97478 SCOPE: Mechanical Only
ASSESOR'S PARCEL NO: 1702343200400 TYPE OF STRUCTURE: Commercial
PROJECT DESCRIPTION: ME-Tenant infill
OWNER: FEDAK DARYL A Phone Number:
ADDRESS: 85788 PARKLAND CIR
PLEASANT HILL OR 97455
CONTRACTOR INFORMATION
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
Mechanical Contractor INNOVATIVE AIR INC CCB 161742 10111/2014 541-746-1040
General Contractor MCINTYRE CONSTRUCTION INC CCB• 3550 10/08/2015 541-687-2841
INSPECTIONS REQUIRED
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 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
cgon.
// ()7 o/3
Owner or Contractor Signature Date
•
NOTICE:
ATTENTION:orule Oregon law requires Oregon Util ty THIS PERMIT SHALL EXPIRE IF THE WORK
follow rules adopted by AUTHORIZED UNDER THIS PERMIT IS NOT
Notification Center. Those rules are t COMMENCED OR IS ABANDONED FOR
in OAR 952-001-0010 through OAR 952-001-
0090. You may obtain copies of the rules by ANY 180 DAY PERIOD.
calling the center. (Note: the telephone
number Center is 1-800-332-2344).
Notification
Springfield Building Permit 11/21/201 10:01:41AM Page 1 of 1
SPRINGFIELD - CITY OF SPRINGFIELD
_:14 A• 225 Fifth SI
_( (31 GON TRANSACTION RECEIPT Springheld,OR 97477
541-726-3753
811-SPR2013-01850
www.springfield-ar.gov 5880 MAIN ST permitcenter@springfield-or.goy
RECEIPT NO: 2013002550 RECORD NO:811-SPR2013-01850 DATE: 11/21/2013
DESCRIPTION A • ACCOUNT CODE/TRANS CODE. ? `: •„. AMOUNT,DUE
Mechanical Permit fee(based on value of work) 224-00000-425604 1006 286.52
State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 34.38
Technology fee(5%of permit total) 100-00000-425605 2099 14.33
TOTAL DUE: 335.23
L PAYMENT TYPE , - PAYORCASHIER:CCARFENTER COMMENTS_: " AMOUNT PAID. '
Credit Card INNOVATIVE AIR INC 335.23
04549c
TOTAL PAID: 335.23
Mechanical Permit Application DEPARTMENT USE ONLY
SPRINGFIELD
x w CITY OF SPRINGFIELD! OREGON 1° '. s Permit no.: SI�7J /7 co
z&*an8.ri+tr k •y� st
225 Fifth Street ♦ Springfield,OR 97477• P11(541)726-3753 • FAX(541)726 3689 =-roacGON Date: /// 2 7/ 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. Cast Tostl
JOB SITE INFORMATION AND LOCATION First Appliance $80.00 $
Job site address: 4- mai,.q 4- Furnace/burner including duets and vents
City: (ta. Oer� State: O ZIP: l'f�7t/77 Up to IOOk B'flJlhr. _ $18.50 $
�I S
Over I 00 BTU/hr. $22.00 $
Reference: Taxlot.:
Heaters/stoves/vents
II DESCRIPTION OF WORK Unit heater $18.50 S
'-Iv'f C for -rT- Wood/pellet/gas stove/flue $42.00 $
Repair/alter/add to heating appliance!
refrigeration unit or cooling system/ $80.00 $
PROPERTY OWNER absorption system
Name: fr 2�� Evaporated cooler $14.50 $
Address: % 5 / / t nf71✓/' G/2C. Vent fun with one duel/appliance vent $t 0.00 $
//�, Hood with exhaust and duel $14.50 S
City: LAS /f§I/Ste: (l/L_ ZIP:�f7Y5J Floor furnace including vent $80.00 $
Phone: - - Fax: - - • Gas piping
E-mail: One to four outlets $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 _ $12.00 $
Signature: Over 10.00(1 CFM $22.00 _S
CONTRACTOR INSTALLATION Compressor/absorption system/heat pump
L ,/ Up to 3 hp/I 00k IS 11-1 $18.50 $
Business name: J_r.-1/,IJ QA T i^e. /i ,r
Up to 15 hp/500k RT(J $32.00 $
Address: S[p?o Efatik/y,,.l &uJ- Up to 30 hp/1,000 BTU S47.50 S
City: ?,K9,t Stale: 012 ZIP: q7 c/o) Up to 50hpi1,750 BTU $62.50 $
Phone: - - 796-/pyv Fax: - - Over 50 hp/1.750 BTU $104,50 $ .
F.-nail: fob f " 4tcb..✓ . ! �✓t Incinerators
P 'NKo
Domestic incinerator $22.50
CC[i license no.: lb
Commercial
Print name: ?o6 jQ ep Enter total valuation of mechanical system
Signature: 44. rsapp and installation costs$
/ 2 ► /41 y Enter fee based on valuation of mechanical sysf tem.etc. $
Miscellaneous fees Items Cost total
ea. cost
Reinspeetion $80.00 $
Specially requested inspections(per hr.) $80.00 $
Regulated equipment(unclassed) $14.50 $
•
Each additional inspection: (I) $80.00_._.5 --
APPLICANT USE
(A)Enter subtotal of above fees(or enter set �1 S Z
minimum fee of $80.00) $ / i
(R)Investigative fee(equal to[Al) $
(C)Enter 12%surcharge(.12 x[A'R]) $ al
. ID)Seismic fee. 1%(.01 x IAl) _ $ �(
(F)Technology Fee(5%of[A[) $ /eiL
440.25=154 0/I/2013/COtvp TOTAL fees and surcharges(A through I:):• $ ��'