HomeMy WebLinkAboutPermit Mechanical 2013-12-23 SPRINGFIELD- • 225 Fifth St
CITY OF SPRINGFIELD Sp ngfeld,OR 97477
% i Phone: 541-726-3753
OREGON Building / Residential Permit Inspection Phone:541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2013-02726
www.springfieldar.gov permitcenter @springfield-ar.gav
PROJECT STATUS: Issued ISSUED: 12/23/2013 EXPIRES: 06/21/2014
STATUS DATE: 12/23/2013 APPLIED: 12/23/2013
SITE ADDRESS: 2066 G ST,Springfield,OR 97477 SCOPE: Heating System
ASSESOR'S PARCEL NO: 1703361205500 TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION: Heat pump and furnace .
OWNER: ALVAREZ ALEJANDRO ABARCA Phone Number:
ADDRESS: 2066 G ST
SPRINGFIELD OR 97477
- • CONTRACTOR INFORMATION
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
Mechanical Contractor OWNER CCB 000000 08/01/2025
Electrical Contractor OWNER CCB 000000 08/01/2025
INSPECTIONS REQUIRED Y
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 inspe �r° -•1 ested at the proper time, that each address is readable from the street,that the
permit card is located at-the r• perty, aid-the approved set of plans will remain on the site at all times during
construction. � • •
12- 23- 1S
Owner or Contractor Signature Date - .
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uo!veD 1UoN �i!I!1(1 U06a 0 atjl JO logwnu NOTICE:
auoL!dajai eqi :OTON) 'fawao au1 6u j o THIS PERMIT SHALL EXPIRE IF THE WORK
Aq sejnn eqi in sa!doo u!eigo tew no% '0600 AUTHORIZED UNDER THIS PERMIT IS NOT
-L00-W UV() Orlon -L00 Uo! UNO u!
ylaoi 1as are sajna asot!1 'aaiva0 uo!1so!140N COMMENCED OR IS ABANDONED FOR
Aill4(1 ANY 180 DAY PERIOD.
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•
Springfield Building Permit 12/23/201 1:34:54PM Page 1 of 1
SPRINGFIELD' - CITY OF SPRINGFIELD
,, TRANSACTION RECEIPT Spnngfield,OR 97477
541-726-3753
OREGON 811-SPR2013-02726
www.spring5eld-or.goy 2066 G ST permitcenter @spnngfield-or.gov
RECEIPT NO: 2013002727 RECORD NO: 811-SPR2013-02726 DATE: 12/23/2013
10141g illia tlto Z - 5` ,•, >V 'r'I" ° CCOUNT CODEFTRANS?CODE. '`.i r-AMOUNTI&DUE
First Appliance Fee 224-00000-425604 1006 80.00
Furnace-up to 100,000 BTU 224-00000-425604 1006 18.50
State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 - 11.82
Technology fee(5%of permit total) 100-00000-425605 2099 4.93
TOTAL DUE: 115.25
.....�-�......T.... tg w� ...-..T a.:9f 31 AMOUNT FAIR l
� P'AY,MENTm1YPE i-��".`�--s'PAYO�R .�casHie""n�.iia'RSOr' �="6`"., "COMMENTS.„•t' � .. � " `_ .. .
Cash ALVAREZ ALEJANDRO ABARCA 115.25
TOTAL PAID: 115.25
Mechanical Permit Application DEPARTMENT USE ONLY
17'.- CITY OESPRING FIELD OREGONF U '_ y - Permit no.:i/j-Q Z-70- ( '
225 Fifth Street • Springfield,OR 97477 • PH(541)726 3753 • FAX1541)726-3689 '''\`OREGON Date: /2- 0 3/
' This permit is issued under OAR 918-440-0050. Permits expire if work is not started within ISO clays of issuance or if work is
suspended for ISO days.
CATEGORY OF CONSTRUCTION FEE SCHEDULE
Residential ❑Government ❑Commercial Residential Qty Coll Total ea. cost
JOB SITE INFORMATION AND LOCATION First Appliance $80.00 $
Job site address: 20 ti 5 1 Furnace/burner including ducts and vents
10 City: cer:n C: State:b f'_ ZIP: `r/20 Up n 100k H'IU!hr. $18.50
J 7b33 Over IOOk BfU.hr. $22.00
Rel'zt.ence: / 'FasIoLS rQV
Unit Heaters/stoves/vents
DESCRIPTION OF WORK
Unit heater $18.50
iii(e*. E Ca 1 ti/e lo Wood/pelletigas stove/Ilue $42.00 S
Repair/alter/add to heating appliance/
i - -I-N A 1 s 4 - . • / i 0— refrigeration unit or cooling system/ $80.00 S
PROPE-TY OWNER absorption system
Name: J I , . r— Evaporated cooler $14.50 $
Address: 9 v C 6' l s Vent fan with one duct/appliance vent $10.00 S
111 hood with exhaust and duet $14.50 S
City: SeYtI /x .0 State: O ZIP?7 9 7 7 Floor furnace including vent $60.00 $
Phone: Sr 1I -S . titg 03 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 front licensing Air-handling units, including ducts
requirements under ORS 701.010. Up to 10.000 CFh1 $12.00 $
Signature: Over 10.000 CFX1 $22.00 $
CONTRACTOR INSTALLATION Compressor/absorption system/heat pump
Lip to 3 hp!100k BTU $18.50 $
Business name: d 1./A(Cr Up to 15 hp'500k BTU $32.00 $
Address: Up to 30 Itp/I.Ot)t) BTU $47.50 $
City: State: ZIP: Up to 50 hp/1.750 BTU $62.50 S
Phone: - - Fax: - - Over 50 hp/1.750 BTU $104.50 $
E-mail: Incinerators
Domestic incinerator $22.50 $
CCl3 license no.: Commercial .
Print name: Enter total valuation of mechanical s'Stetn
and installation costs$
Signature:
Enter fee based on valuation of mechanical system,etc. $
Miscellaneous fees trees Cost Total
ea. Cost
•
ILeinspectiob $80.00 $
Specially requested inspections(per hr.) $80.00 $
• Regulated equipment(unclassed) $14.50 $
Each additional inspection: (I) $80.00 S
. APPLICANT USE
(A)Enter subtotal of above fees(or enter set
nimum fee of 5 80.00) $ ?Sr 10
/ -
(0)Investigative fee(equal to[AD S
(C)Enter 12%surcharge(.12 x]A+BJ) $ //la
(D)Seismic fee. 1%1.01 x[AI) $
(IC)Technology Fee(5%of[A]) $ tin-
4.10-2545-1(4/1/2013/COM) TOTAL fees and surcharges(A through E): $ 2 r