HomeMy WebLinkAboutPermit Mechanical 2014-1-9 ISPRINGFIELD 225 Fifth St
'ar%. A.' CITY OF SPRINGFIELD Springfield,OR 97477
W;, tor Phone: 541-726-3753
OREGON Building / Residential Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2014-00051
www.springfield-or.gov permitcenter @springfiel d-or.gav
PROJECT STATUS: Issued ISSUED: 01/09/2014 EXPIRES: 07/08/2014
STATUS DATE: 01/09/2014 APPLIED: 01/09/2014
SITE ADDRESS: 1706 E ST,Springfield,OR 97477 SCOPE: Mechanical Only
ASSESOR'S PARCEL NO: 1703362118100 TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION: ME-Replumb kitchen and bath
OWNER: DMH INVESTMENTS LLC Phone Number:
ADDRESS: 780 S 57TH ST
SPRINGFIELD OR 97478
I, CONTRACTOR INFORMATION
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
OWNER CCB 000000 08/01/2025
_ 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.
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Owner or Contractor Signature Date
ATTENTION: Oregon law requires you to NOTICE:
follow rules adopted by the Oregon Utility THIS PERMIT SHALL EXPIRE IF THE WORK
Notification Center. Those rules are set forth AUTHORIZED UNDER THIS PERMIT IS NOT
in OAR 952-001-0010 through OAR 952-001-
0090. You may obtain copies of the rules by COMMENCED OR IS ABANDONED FOR .
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calling the center. (Note: the telephone ANY 180 DAY PERIOD.
number for the Oregon Utility Notification
Center is 1-800-332-2344).
• Springfield Building Permit 1/9/2014 10:49:56AM Page 1 of 1
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. SPRINGFIELD CITY OF SPRINGFIELD
,$ it n ..ne.- 225 Fifth St
�
`?' TRANSACTION RECEIPT Springfield,OR97477
OREGON 541-726-3753
- 811-S PR2014-00051
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www.springfield-or.gov 1706 E ST permitcenter @springfield-or.gov
RECEIPT NO: 2014000044 RECORD NO:811-SPR2014-00051 DATE:01/09/2014
(DESCRIPTION - ; r .-- ACCOUNT-CODE/TRANS CODE" _ AMOUNTDUE_'_I
First Appliance Fee 224-00000-425604 1006 80.00
Single-duct exhaust(bathrooms,toilet compartments, utility room: 224-00000-425604 1006 20.00
State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 12.00
Technology fee(5%of permit total) 100-00000-425605 2099 5.00
TOTAL DUE: 117.00
L ` - AMOUNT PAID. -"
PAYMENT TYPE . PAYOR_- cnsRieR:ccnRPeRrEa 'COMMENTS: - - c -
Check DMH INVESTMENTS LLC -- 117.00
1106
TOTAL PAID: 117.00
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Mechanical Permit Application DEPARTMENT,USE ONLY -
1{ww" r .s ?yam R44,tt:r xy SPRINGFlELU ...o•am; `1 yy,,, '
-, air ' , wed R �.a 'z .,, . ' - 5(9 --x.57
CITY:OFSPRINGEIELD �I�CrOr a Permit no.:
'225 Fifth Street• Springfield,OR 97477 ♦ PH(541)726-3753 • FAX(541)726-3689 i' ' .r. , $0. '} Date: //9/(/�
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`ATEGORNiOF11,CONSTRUCTION „ . [z„'! 3 '"� _ ' ` #
.� _. .. :,,y� , a.. r??,� .v�.4.FEE SCHEDULE , �: �' ..
❑Residential ❑Government ❑Commercial ',Residential r S' n " Y Qty ,Least k Total i.Y
. ^ JOB`SITE„INFORMATION; AND LOCATION cost6 .
i,z First Appliance f 580.00 $
Job site address: /� /11/]1.0 D E s-yei.fr Furnace/burner including ducts and vents
City: S pv-6,,C,}r•e,e State:0/2- ZIP: y'�'7 7 Up to 100k BTU/hr. - $18.50 $
/ ✓ Over 100k BTU/hr. $22.00 $
Reference: Taxlot
Rv , ,� ,s„ Heaters/stoves/vents
,k to cg DESCRIPTION AFxWORK„' £1r,, , ,g;;, r ; Unit heater $18.50 $
1•1644) 'Dr,'e - l(ewrt- Wood/pellet/gas stove/flue $42.00 $
t-160 . Mu if Vew� Repair/alter/add to heating appliance/
�a-+ § t _. }. -_ e- ti.. S v,, refrigeration unit or cooling system/ $80.00 S
F}:, >F' ., r'rea gOPER��T't-Y,OWNER a»,`-Fg+ ,t,y '�A ti absorption system
Name: 'n bh 1pyC Evaporated cooler $14.50 $
Address: -,Q s 57 it set- Vent fan with one duct/appliance vent 9(3, $10.00 $20
Hood with exhaust and duct $14.50 $
City: Geier State:piZ ZIPg7975
Floor furnace including vent $80.00 $
Phone: ff7 .-3CC1- /•� Fax: - - Gas piping
E-mail: Jp n m hol��wi /8" 6 rN a 1 ,CO 1'✓1 One to four outlets $7.50 $
This installation is being mac!)
a e 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 $
' °0aGONT Otto RINSTALL"ATION - ,ka t, Compressor/absorption system/heat pump
Up to 3 hp/100k BTU $18.50 $
Business name: eY,AJ/1/(,r'(� Up to 15 hp/500k BTU $32.00 $
Address: Up to 30 hp/1,000 BTU $47.50 $
City: State: ZIP: Up to 50 hp/1,750 BTU $62.50 $
Phone: . - - Fax: - - Over 50 hp/1,750 BTU - $104.50 $
E-mail: Incinerators
Domestic incinerator $22.50 $
CCB license no.: o- v . :�
;Commeecial�,-^v..rs+� sx�m�a�''� r..� :gin t'". '�.�g`'m
Print name: Enter total valuation of mechanical system
and installation costs$
Signature: - Enter fee based on valuation of mechanical system,etc. . $
Mt.:r5?'i ^a a;Fx „r-- •r{.„ _ , -,Cost Total rs'.
iscellaneous fees; Items .ea .'.;cost =a
Reinspection $80.00 $
Specially requested inspections(per hr.) $80.00 $
Regulated equipment(unclassed) $14.50. $
Each additional inspection: (1) $80.00 1 $
' .- t a PPLICANLaUSE4 4"' ,
(A)Enter subtotal of above fees(or enter set 1
minimum fee of $80.00) $ 16d
(B)Investigative fee(equal to [A]) $
(C)Enter 12%surcharge(.l2 x[A-H3]) $ /"1„/
(D)Seismic fee, 1%(.01 x [Al) $
(E)Technology Fee(5%of[Al) $ S
440-2545-1(4/1/2013/COM) TOTAL fees and surcharges(A through E): $ //79-12--
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