HomeMy WebLinkAboutPermit Mechanical 2014-1-9 •
SPRINGFIELD`.. 225 Fifth St
=`' - '
'' t CITY OF SPRINGFIELD Springfield,OR 97477
Phone: 541-726-3753
' OREGON .Building / Residential Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2014-00054
www.springfield-or.gov permitcenter @springfield-or.gov
PROJECT STATUS: Issued ISSUED: 01/09/2014 EXPIRES: 07/08/2014
STATUS DATE: 01109/2014 APPLIED: 01/09/2014
SITE ADDRESS: 967 OLYMPIC ST,Springfield,OR 97477 SCOPE: Mechanical Only
ASSESOR'S PARCEL NO: 1703264202900 TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION: Ductless heatpump
OWNER: SMITH NICHOLAS T Phone Number:
ADDRESS: PO BOX 1265
SPRINGFIELD OR 97477
L CONTRACTOR INFORMATION
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
Mechanical Contractor KENT WTHAM AIR INC • CCB 189283 01/20/2014 541-543-6580
INSPECTIONS REQUIRED
-
Inspections
2999 Final Mechanical Final Mechanical: When all mechanical work is complete. .
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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.
X
Owner or Contractor Signature Date
follow ru! ON• Oregon 1a
n otification Ce dOPted by theequires You to
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o alling the e obtain °Pies i NOTICE:
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Springfield Building Permit 1/9/2014 201:51PM Page 1 of 1
SPRINGFIELD CITY OF SPRINGFIELD
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225 Fifth St
OREGON TRANSACTION RECEIPT Springfield,OR 97477
Lots
541-726-3753
811-S PR2014-00054
www.springfield-or.gov 967 OLYMPIC ST permitcenter @springfield-or.gov
RECEIPT NO: 2014000046 RECORD NO: 811-SPR2014-00054 DATE:01/09/2014
(DESCRIPTION w ` ACCOUNT CODE/TRANS CE NT
OD ' AMOUNT
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
LPAYMENT PAYOR, CASHIER ccaRPENTER �.� ` COMMENTS - • -�- �. AMOUNT PAID' _
Check KENT WITHAM AIR INC 93.60
2454
TOTAL PAID: 93.60
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Mechanical Permit Application ,,,DEPARTMENT USE ONLY
,.,*s £ ^A"'^3yy' e.W. SPRINGFIELD U
f"�'�='�2+�f�'��e '� ��>�� ^w��iy..'Grf¢Xitrr.iy21'i..[..c°s.S:. zz..'y � 1 _
- $ITaO �SERINGEIELD OREGON i( I Permit no.: 000 JY
`Pik �'a^5+tt:Rbua�R.!s, �,
225 Fifth Street• Springfield,OR 97477 • PH(541)726-3753 • FAX(541)726-3689 Li.,, "I; Date: 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.
C" ,, ,, ',G/1TEGORY OFt,CONSTRUCTION ` ,`r.i. ,' ,1 „ , &. FEE;SCHEDULE „ „. t
$ ` 5 L Tota 'r'-Residential ❑ Government ❑ Commercial Resldentlal 4 Qtyt,
"; [ JOB„SITE INFORMATION AND =LOCATION,5itil'aia First Appliance 7 580.00 $J2)
Job site address: ( (07 01 ym$Y'c Furnace/burner including ducts and vents
Up w 100k BTU/hr. .$18.50 $
City Sal r)9.�)r 1d. State: o ZIP: 9797ri
Reference: 770'c 2�7p::Z Taxlot 02.410� Over ers/ BTU/hr. $22.00 $
Heaters/stoves/vents
v ry r °DECRIPTION ,OFWORK;f' '1,igge Unit heater $18.50 $
ri&5 i-a I t Doc- Hess Heat-Poin/
Wood/pellet/gas stove/flue $42.00 $
Repair/alter/add to heating appliance/
refrigeration unit or cooling system/ $80.00 $
. . t 4 PROPE _1w OWNER a9A ; _ At1
absorption system
Name: NI f Gk Apt r I ” Evaporated cooler $14.50 $
Address: �(D7 QO('N1)0%� Vent fan with one duct/appliance vent $10.00 $
7 Hood with exhaust and duct $14.50 $
City: se F- R_D State: 0 ZIP: 1797 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 $
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 $
T`t"-aGONTRACTOR3INSTALLATION4tZ,W,; 7s' Compressor/absorption system/heat pump
Business name: rear' c3 rRoj vl 4;f Up to 3 hp/100k BTU $18.50 $
',75� Up to 15 hp/500k BTU $32.00 $
Address: O Up to 30 hp/1,000 BTU $47.50 $
City: S Pr?ng .-e Id State:o9 ZIP: 97777 Up to 50 hp/1,750 BTU $62.50 $
Phone6yi-53/3-6,530 Fax:3tf -1,3(o- 4Qo24 Over 50hp/1,750 BTU $104.50 $
E-mail: Kogjr oq g gef-t✓1Qj( .,(.aW1 Incinerators
Domestic incinerator $22 50 $
CCB license no.: 18C) a33 . „,
1 Commercial 't,`rs���,,, , y,�,,1 ti:� ,zfif
Print name: #cPy\+ *Actyyl Enter total valuation of mechanical system
and installation costs S
Signature: _ ___(.4 airwe Enter fee based on valuation of mechanical system,etc. $
` r .xi:R.6"5" ' ,.; r ,s " ."Cost Total %;
rillMlscellaoeous fees, i Items dt
,.�.- _ r� ..�< z . :ea. ..Cost,
- Reinspection $80.00 $
Specially requested inspections(per hr.) $80.00 $
Regulated equipment(unclassed) $14.50. $
Each additional inspection:(1) $80.00 $
N:A l l"t :APPLICANT_,USE `e"if ,',, . tl
(A)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+B]) $
(D) Seismic fee, I%(.01 x[A]) $
(E)Technology Fee(5%of[A]) $ 9g/,,
440-2545-J(4/1/2013/COM) TOTAL fees and surcharges (A through E): SC13 o