HomeMy WebLinkAboutPermit Mechanical 2013-11-19 •
SPRINGFIELD � •• 225 Fifth St
'' CITY OF SPRINGFIELD Springfield,OR 97477
CC l� Phone: 541-726-3753
"'t` OREGON Building I Residential Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2013-02535
www.springfield-or.gov permitcenter @springfieId-or.gov
PROJECT STATUS: Issued ISSUED: 11119/2013 EXPIRES: 05/18/2014
STATUS DATE: 11/19/2013 APPLIED: 11/19/2013
SITE ADDRESS: 1034 4TH ST,Springfield,OR 97477 SCOPE: Mechanical Only
ASSESOR'S PARCEL NO: 1703352104000 TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION: Bath fan
OWNER: STERUP CHRISTOPHER&POPPIE Phone Number: 541-214-4603
ADDRESS: 1034 4TH ST
SPRINGFIELD OR 97477 •
•
CONTRACTOR INFORMATION
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
Mechanical Contractor J 8 V HOME IMPROVEMENT CONTRACTORS INC CCB 96579 02/08/2014 541-895-4722
L 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
construction.
�,���e�; // —79
Own- or Cc tractor Signature Date
AT
Oregon law he prep n e ti dY
NOTICE: ioilow rules adopteTho e rules are sett001-
Center. h OAR 952
THIS PERMIT SHALL EXPIRE IF THE WORK Notification p01 0010 throu9
AUTHORIZED UNDER THIS PERMIT IS NOT ip0 oRyo�maY obtainNotE1h'e telephone Y
COMMENCED OR IS ABANDONED FOR °Sling P8 ieeiOre g00332t2344)itcation
ANY 180 DAY PERIOD.
Springfield Building Permit 11/19/201 11:40:43AM Page 1 of 1
SPRINGFIELD CITY OF SPRINGFIELD
4 a 225 Fifth St
g tia;; TRANSACTION RECEIPT 225 Fifth
SOR97477
OREGON 541-726-3753
811-SPR2013-02535
www.springfield-or gov 1034 4TH ST permitcenter @springfield-or.gov
RECEIPT NO: 2013002527 RECORD NO: 811-SPR2013-02535 DATE: 11/19/2013
DESCRIPTION . -. . ACCOUNTCODE/TRANS CODE ;-.1-AMOUNT„DUE
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
L„.P,AYMENT TYPE - PAYOR. '. cnsxlER:ccnRPEx7eR -__ ,COMMENTS_.. ” . , !AMOUNT P A I D -.
Credit Card J&V HOME IMPROVEMENT ___. 93.60^���
019319 CONTRACTORS INC
TOTAL PAID: . 93.60
Mechanical Permit Application DEPARTMENT USE ONLY
v _- $PpINGF1ELD-
:- ATV OF SPRINGFIELD OREGON Permit no.: S(�—2C,?C
225 Fifth Street•Springfield,OR 97477 • P11(541)726-3753 • FAX(541)726-3689 „ OREGON Date: it( S
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
,<esidential ❑Government ❑Commercial Residential Qty. Cost Total
ea. n
JOB SITE INFORMATION AND LOCATION First Appliance / 580.00 _ $
Job site address: //05V ./e? 5 A Furnace/burner including ducts and vents
City: 5yre„(4,{� State: �2 ZIP:97/7 '7 Up to I OOk BTU/Iv. S18.50 $
/(J Over 100k KTUiltr. $22.00 $
Reference: Taxlot.:
Unit Heaters/stoves/vents
DESCRIPTION OF WORK
Unit heater $18.50 $
grave 10 7-20,•-•S 02 �,ea.I Wood/pellet/gas stove.Rlue $42.00 $
ent � �rr4 /r j 1 7 ,5. Repair/alter/add to heating appliance/
L ....JJ//�� refrigeration unit or cooling systenV $80.00 $
PROPERTY OWNER absorption system
�1i S „�� �J .�,_.n Evaporat -conter $14.50 $
Name: !%/? i�/•%' / Yfi�"�"
Address: �p} +� S' u,f ant fan with one ducUapp nee vent $10.00 $
wilh.exheus nd duct $14.50 $
City: 'Sj� �� State: a/Z ZIP:9791"17 Floor furnace including vent $80.00 $•
Phone: 5941- 9$4o3 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 $
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
t Up to 3 hp/100k BTU $18.50 $
(
Business name: � f ✓ /.(qµe �j
yP Up to 15 hp/500k BTU I $32.00 $
Address: ?, a /SEM' 72.-5/ Up to 30 hp/1.000 BTU I $47.50 $
City: efesw 62f Statev.0 ZIP: 97f 'ze, Up to 50 hp/1.750 BTU $62.501 $ _
Phone: ,S1-- 17ZZ Fax: - - Over 50 hp/1.750 BTU $104.50 I $
E-mail: Incinerators
9�5 I� Domestic incinerator - $22.50 $
CCB license no.: -
,/ / Commercial
Print name: .l.,t.7 l/40- K/j't-I Enter total valuation of mechanical system
and installation costs$
Signature: - Enter fee based on valuation of mechanical system.etc. $
Miscellaneous fees items Cost Total
ea. cost
Reinspection $80.00 $
Specially requested inspections(per hr.) $80.00 $
- Regulated equipment(unclassed) $14.50 $
Each additional inspection:(1) $80.00 $
APPLICANT USE
(A)Enter subtotal of above fees(or enter set �•1
minimum fee of $80.00) '(/
(13)Investigative fee(equal to[A]) $
(C)Enter 12%surcharge(.12 x[A+B]) $90
(D)Seismic fee, I%(.01 x[A]) $ ���
(E)Technology Fee(5%of[Al) $ C l
440-2545-1(4/12013/COM) TOTAL fees and surcharges(A through L): $ /V