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HomeMy WebLinkAboutPermit Mechanical 2014-1-14 • SPRINGFIELD 225 Fifth St ,..EL- CITY OF SPRINGFIELD Springfield,OR 97477 ____i_____ii t� Phone: 541-726-3753 ON6GON Building I Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2014-00098 www.springtield-or.gov permitcenter @springfield-or.gov • PROJECT STATUS: Issued ISSUED: 01/14/2014 EXPIRES: 07/13/2014 STATUS DATE: 01/14/2014 APPLIED: 01/14/2014 SITE ADDRESS: 2687 3RD ST,Springfield,OR 97477 SCOPE: Pellet Stove/Insert ASSESOR'S PARCEL NO: 1703233404600 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Gas piping and gas insert OWNER: JENKINS MARY JO Phone Number: ADDRESS: 2687 N 3RD ST SPRINGFIELD OR 97477 CONTRACTOR INFORMATION 1 Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone Mechanical Contractor AMERICAN GAS APPLIANCE SERVICE INC GCB 77621 10/31/2014 541-954-4585 L . INSPECTIONS REQUIRED 11 Inspections 2210 Underfloor Gas Underfloor Gas: After line is installed and required testing and capped if not attached to an appliance. 2255 Gas Pressure Test 2300 Rough Mechanical Rough Mechanical: Prior to Cover 2310 Rough Gas Rough Gas: After line is installed and required testing and capped if not attached to an appliance. 2995 Final Gas Final Gas: When all gas work is complete. 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 . constructio / ifi k 4--7 Owner or Contractor Signature Date NOTICE: ATTENTION: Oregon law requires you to THIS PERMIT SHALL EXPIRE IF THE WORK follow rules adopted by the Oregon Utility AUTHORIZED UNDER THIS PERMIT IS NOT Notification Center. Those rules are set forth COMMENCED OR IS ABANDONED FOR AR 0 through A ANY 180 DAY PERIOD. 009 in O0. You may 952-001-001 obtain copies o Of the calling the center. (Note: the telephone rules by •Springfield Building Permit 1/14/2014 1:49:26PM number for the Oregon Utility Notification Page 1 of 1 Center is 1-800-332-2344). • SPRINGFIELD CITY OF SPRINGFIELD ______ ti it.i. .. 225 Fifth St iiiithi—_c,, TRANSACTION RECEIPT Springfield,OR 97477 OREGON 541-726-3753 811-SPR2014-00098 www.springfield-or.gov • 2687 3RD ST pennitcenter©springfield-or.gov RECEIPT NO: 2014000091 RECORD NO: 811-SPR2014-00098 DATE:01/14/2014 [DESCRIPTION ACCOUNT CODE/TRANS,CODE AMOUNT DUE ` First Appliance Fee 224-00000-425604 1006 80.00 Gas Piping up to 4 outlets 224-00000-425604 1006 7.50 • State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 10.50 Technology fee(5%of permit total) 100-00000-425605 2099 4.38 TOTAL DUE: 102.38 L PAYMENT TYPE' . _PAYOR_ CASHIER:CCARPENTER • _._. _COMMENTS , ,,; , I• AMOUNT PAID m ) Credit Card AMERICAN GAS APPLIANCE SERVIC 102.38 057537 INC TOTAL PAID: 102.38 • • • • • • Mechanical Permit Application DEPART\TMlENTUSEE:OgN/LY ty 0Z24511k1 SP M,N,CFI EL D ra. ( '' Permit no.: CITY OF SPRINGFIELD AN 3 r" RFC rite 225 Fifth Street♦ Springfield,OR 97477 ♦ PH(541)726-3753 ♦ FAX(541)726-3689 : �y. Date: V/1(7I L7 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. '` ' GATEGORYCOF CONSTRUCTION 0 ` "'�' "FEE SCHEDULE ,' _; ,, . .. esidential ❑Government ❑Commercial „.Residential 't ` u t Qty`t Cost Total t ..,a r'ea ,. Secosh »;s+ JOB-;SITE -INFORMATION AND, LOCATION „5 First Appliance ( $80.00 $ Job site address. Zl.�87 /e(< <�j�� Furnace/burner including ducts and vents City: _ P,Aznetr) - State: ZIP: � 7 Up to 100k BTU/hr. $18.50 $ Reference ^�'77 �{ �j v Taxloi G�j(p� Over 100k BTU/hr. $22.00 $ ,,,¢ , //-,/ J� Heaters/stoves/vents -/ , .rte v/_ :�jDESCRIPTIONi OF�*.WORK fit,,, ; ,' '' Unit heater • $18.50 $ (x/45 /j ig it 6'4j 1't-4Ce A,5j6Q/ Wood/pellet/gas stove/flue $42.00 $ Repair/alter/add to heating appliance/ refrigeration unit or cooling system/ $80.00 $ w aA . ewJPROPERTW'OWNERK{z.' a t t,'.sc S absorption system Name 17/202y j, JersK.,„!� Evaporated cooler -$14.50 $ Address: Z4,87 „v. 3 - Vent fan with'one duct/appliance vent $10.00 $ S,Pe�.tr � —7 Hood with exhaust and duct $14.50 $ City G / , State: ZIP: 7/ Floor furnace including vent $80.00 $ Phone: sCy- c`j2/ zg9So Fax: - - Gas piping - E-mail: - One to four outlets / $7.50 $76 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 $ ,i „a?'C_ONT ACTOR INSTALL JON X-+'`„` ) - "tt Compressor/absorption system/heat pump Business name j 4a 11C ! � 1tiAnCZ% Jf« lip to 3 hp/]OOk BTU $18.50 $ Up to l5 hp/SOOk BTU $32.00 $ Address: (/8 /YAy+1ILrp 5r 7 Up to 30 hp/],000 BTU $47.50 $ City: ,4424,44p4z� �State:� ZIP:*1777 Up to 50 hp/1,750 BTU $62.50 $ Phone: j 4/- 95444 Z Fax 7( r 87,36' Over 50 hp/1,750 BTU $104.50 $ E-mail: Incinerators Domestic incerator � 4 $22 5.0 $ CCB license no.: 7 7 6 �/ - 'CORmercia ok r2r 1} + 'C :p x T. :65' : Print name: W14/e. / t (l( Enter total valuation of mechanical system and installation costs$ Signature: // ,,// 6dq,1 Enter fee based on valuation of mechanical system,etc. . $ Mscellaneousfees`. 1)Li 47tems1- cast I`costx'A Reinspection $80.00 $ Specially requested inspections(per hr.) $80.00 $ Regulated equipment(unclassed) $14.50. $ Each additional inspection:(I) $80.00 $ . :.mss , ; e: t A”APPLICANT;°USE.0} :,1 _",,,n. !,S4. ;1, (A)Enter subtotal of above fees(or enter set V minimum fee of $80.00) $ (B)Investigative fee(equal to[A]) $ (C)Enter 12%surcharge(.12 x[A+B]) $ j ) (D) Seismic fee, 1%(.01 x[A]) _ $ (E)Technology Fee(5%of[A]) 3 440-2545-1(4/1/2013/COM) . TOTAL fees and surcharges(A through E): $ {Q�q�