HomeMy WebLinkAboutPermit Mechanical 2014-1-15 SPRINtiIELD --'
225 Fifth St
CITY OF SPRINGFIELD Springfield,OR 97477
tt � Phone: 541-726-3753
OREGON Building I Commercial Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2014-00106 •
www.springfield-or.gov permitcenter @springfield-or.gov
PROJECT STATUS: Issued .ISSUED: 01/15/2014 EXPIRES: 07/14/2014
STATUS DATE: 01/15/2014 APPLIED: 01/15/2014
SITE ADDRESS: 188 W B ST,Springfield,OR 97477 SCOPE: Mechanical Only
ASSESOR'S PARCEL NO: 1703352312401 TYPE OF STRUCTURE: Commercial
PROJECT DESCRIPTION: Replace H.P.and air handler
OWNER: MCCULLOCH ROBERT&JEANETTE Phone Number:
ADDRESS: 735 ASPEN ST
SPRINGFIELD OR 97477
CONTRACTOR INFORMATION
-
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
Mechanical Contractor WESTSIDE HEATING 8 AIR CONDITIONING INC CCB 192774 02/08/2015 541-357-4355
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.
Owner or Contractor Signature Date
uitO5 you to ;.
on law fie Oregon Utility
ATTENTION Ore ed by NOTICE:
follow rules adop h OAR 952-001
Notification Center. Those rules are set forth THIS PERMIT IS NOT
52-001-0010 throng THIS PERMIT SHALL EXPIRE 1F THE WO
ps e the rules by AUThORIZED UNDER OR
in OAR 9 obtain copies hone
0090. You may Note; the telep COMftnENCED OR IS ABANDONED F
calling the center. lot utility Notification Y PERIOD.
number for the
Ore9 ANY 180 DA
Oenter Is 1 300-332-2344 .
Springfield Building Permit 1/15/2014 11 16:08AM Page 1 of 1
SPRINGFIELD CITY OF SPRINGFIELD
225 Fah St
TRANSACTION RECEIPT Springfield,OR97477
OREGON 541-726-3753
811-S PR2014-00106
www 96946field-or.gov 188 W B ST permitcenter @springfield-or.gov
RECEIPT NO: 2014000100 RECORD NO:811-SPR2014-00106 DATE:01/15/2014
(DESCRIPTION ACCOUNT,CODE/TRANSCODE AMOUNT_DUE,,:'.
Mechanical Permit fee(based on value of work) 224-00000-425604 1006 110.98
State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 13.32
Technology fee(5%of permit total) 100-00000-425605 2099 5.55
TOTAL DUE: 129.85
. . _ _.. AMOUNT-PAID: '-.' , -r_PAYMENT TYPE "rPAYOR casNIER:ccnRPENreR_ COMMENTS I
Credit Card WESTSIDE HEATING&AIR 129.85
036803 CONDITIONING INC
TOTAL PAID: 129.85
Mechanical Permit Application DEPARTMENT USE ONLY '
-,yr ayy ..J.nk •�yy.._ .y- SPHINGFIELU ��
` C�'Ia ICY. OF SPRINGEIFsLW REG0!I 1 ' FIELD Permit no.: `5(9' '
225 Fifth Street♦ Springfield,OR 97477 • PH(541)726-3753 • FAX(541)726 3689 ,t Date: ///S // 7
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! OI;nCONSTRUCTION- 1, ' k. „ <;,; ,_''A-:. 't ;`FEE SCHEDULE' 2 1'` '' '
� t1Y.: Ir4 R tx'L u ' t f,a r';COSt4 Total
❑Residential ❑ Government ❑Commercial .;Residential l n r�$ Qty. ,tea s• -)/ ?'cost
*. \JOBtSITE [NFORMATION AND ;LOCATION x I t First Appliance $80.00 $
Job site address: /'B 5 tA2. 8 A/.-L' Furnace/burner including ducts and vents
City: 4ptjn /.Q"LI State: Olt ZIP:9 7q-i 7 Up to 100k BTU/hr. $18.50 $
Over 100k BTU/hr. $ 2.00 $
Reference.l7 55-25 Taxlot � U
„ t< l
Heaters/stoves/vents
„> � c s,. , �, DESCRIPTION,OF.;WORK: `;, p i1 Unit heater $18.50 $
' kiLc n/OJCQ (4l .r-T yv4 t .0 Wood/pellet/gas stove/flue $42.00 $
ail(' �✓KSIe✓ / Repair/alter/add to heating appliance/
I I _ i•+-' __ r 4„ f* ,„r refrigeration unit or cooling system/ $80.00 $
3.+,'_�t--1 l`$ , ru..t, tpRQPERTY.OWNER gy'1' „+yMA�. absorption system
Name: 'Ob A4c L`i///OVar- Evaporated cooler $14.50 $
Address: �j W, g 1^/ •-�/ Vent fan with one duct/appliance vent $10.00 $
f�j Hood with exhaust and duct $14.50 $
City:�(jmit ie I c State: 02 ZIP:171(77
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 $
01,7"1:0417.0101:01kIKSTALLATIO VE 'T"; y .* Compressor/absorption system/heat pump
Up to 3 Business name: W431i4z_Near,i9 e - vJ 4av"t'-j .i•-7'C Up to 15 hp/000 BTU
BTU $32.00 $
Address: N' p-. gay!-227°5 Up to 30 hp/1,000 BTU $47.50 $
City:p..9€07c State: 011 ZIP/7C/t2 Up to 50 hp/1,750 BTU $62.50 $
Phone911-357 9,353- Fax: - - Over 50 hp/1,750 BTU $104.50 $
,!E-mail: We$15/deGeratly y l _ e/ . 4-4.4.-1. Incinerators
CCB license no.: /tJ 277L/ Domestic incinerator $22.50 $
rC6t17fr1efeiMI'tk4+.]3*:# ')I w`'. k,.'.' ,.,irrl
Print name: Jo/v7 _ ort.,6 Enter total valuation of mechanical system
e
and installation costs$41i
Signature: .�'sf Enter fee based on valuation of mechanical system,etc $
T Thrfyy'3+M r t-ti;:s ih'a S A s's `' Cost ` Total le
;Mlsce[latieous fees , .e Items
Reinspection $80.00 $
Specially requested inspections(per hr.) $80.00 $
Regulated equipment(unclassed) $14.50. $
Each additional inspection:(I) $80.00 $
3"' 'I`s: W4I .? APPLICANT„ USE ` 1 , wfr-1a
(A)Enter subtotal of above fees(or enter set 3 /a 7r
minimum fee of $80.00) _ I
(B)Investigative fee(equal to[A]) $
(C)Enter 12%surcharge(.12 x[A+B]) $ ) 3 ;L
(D)Seismic fee, I%(.01 x[A]) $
(E)Technology Fee(5%of[A]) $ S''Sj
440-25451(4/1/2013/COM) • TOTAL fees and surcharges(A through E): $j1�!JS