HomeMy WebLinkAboutPermit Mechanical 2014-1-24 ' SPRINGFIELD 225 Fifth St
J CITY OF SPRINGFIELD Springfield,OR 97477
1 11111E2 Phone: 541-726-3753
°Rigor.' Building I Residential Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2013-01441
wwwspnngtield-or gov permitcenter @spnngfield-or.gov
PROJECT STATUS: Issued ISSUED: 01/2412014 EXPIRES: 07/23/2014
STATUS DATE: 01/24/2014 APPLIED: 06/27/2013
SITE ADDRESS: 5233 HIGH BANKS RD, Springfield,OR 97477 SCOPE: Mechanical Only
ASSESOR'S PARCEL NO: 1702283401000 TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION: MEC -New SFD- Lot 2 Thurston PI SAMEAS 5211 Lot 1
OWNER: CUMMINS INVESTMENTS LLC Phone Number:
ADDRESS: 31221 OSPREY RD
LEBANON OR 97355
CONTRACTOR INFORMATION
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
Electrical Contractor EASTSIDE ELECTRIC INC CCB 117770 10/04/2015 541-741-1499
Plumbing Contractor JOHNS PRECISION PLUMBING LLC CCB 158279 0204/2014 541-736-8690
General Contractor DAVIS CONSTRUCTION SERVICES LLC CCB 160347 05/14/2014 541-868-6294
Mechanical Contractor SUNSET HEATING&AIR INC CCB 171706 08;18/2014 541-554-2604
INSPECTIONS REQUIRED
Inspections
2200 Underfloor Mechanical Underfloor Mechanical. Prior to insulation or decking and including required testing
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.
- ( [Hill/
Owner or Contractor Sig ture Date
. . ._ _:KPIRE IF THE WORK
II'E D UNDER THIS PERMIT IS NOT
, :;ED CR IS AGANDONED FOR
r
Springfield Building Permit 1/24/2014 1 54:39PM Page 1 of 1
I
SPRINGFIELD CITY OF SPRINGFIELD
Jig
TRANSACTION RECEIPT 225 Fifth St
Spnngfield,OR97477
OREGON 541-726-3753
811-SPR2013-01441
www springtield-or gov 5233 HIGH BANKS RD permncenter@spnngfieid-or gov
RECEIPT NO: 2014000160 RECORD NO: 811-SPR2013-01441 DATE; 01;2412014
DESCRIPTION ACCOUNT CODE/TRANS CODE AMOUNT DUE
First Appliance Fee 224-00000-425604 1006 80.00
Single-duct exhaust(bathrooms,toilet compartments, utility room: 224-00000-425604 1006 30.00
State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 13.20
Technology fee(5%of permit total) 100-00000-425605 2099 5.50
TOTAL DUE: 128.70
PAYMENT TYPE PAYOR CASHIER:JLARSON COMMENTS AMOUNT PAID
Check CUMMINS INVESTMENTS LLC 128.70
1030
TOTAL PAID: 128.70
Mechanical Permit Application DEPARTMENT USE ONLY
•PRINQF1 LD .-.5.
CITY OF SPRINGFIELD, OREGON ,..e. -. Permit no.:
225 Fifth Street• Springfield,OR 97477 • PH(541)726-3753 • FAX(541)726-3689 Date:
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 OF CONSTRUCTION FEE SCHEDULE
residential Q Government Q Commercial Residential Qty Cost Tatal ea. cost
JOB SITE INFORMATION AND LOCATION First Appliance _ _ $80.00 _ $ •
Job site address: 5-23 3 t p l4 13Amc S i2J. Furnace/burner including ducts and vents
Up to 100k BTU/hr. $18.50 S
City: 5 1rl+.# t is D State: ox ZIP: 9 7L17 9
P Over 100k BTU/hr. $22.00 S
Reference: Taxlot.: Heaters/stoves/vents
DESCRIPTION OF WORK Unit heater $18.50 $
/NE sN 5.F r Wood/pellet/gas stove/flue $42.00 S
Repair/alter/add to heating appliance/
refrigeration unit or cooling system/ $80.00 $
PROPERTY OWNER absorption system
Name: C,/MM/NS /Nv. Lr-c Evaporated cooler _ $14.50 $
Vent fan with one duct/appliance vent $10.00 $
Address: 3122 r o5Plf7 Rol.
Hood with exhaust and duct $14.50 $
City: LA$w4• v p State: 02 ZIP: '37 353-
Floor furnace including vent $80.00 $
Phone: Sy) 2c0 24 So Fax: - - Gas piping
E-mail: 7'E[v,M,Nl e 9„CAST . Ni r One to four outlets $7.50 5
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 701.0I0. Up to 10,000 CFM $12.00 S
Signature: Over 10,000 CFM $22.00 $
CONTRACTOR INSTALLATION Compressor/absorption system/heat pump
Up to 3 hp/100k BTU $18.50 $
Business name: .511/051 T 14 vitC Up to 15 hp/500k BTU $32.00 $
Address: 5-729 Who 57411 i g G1/4 2'f$ Up to 30 hp/1,000 BTU $47.50 S
City: SpgieJbFif'I) I State: OR ZIP: g7Y1$ Up to 50 hp/1,750 BTU $62.50 $
Phone: 5y I -Ai 9 g - 31 g 1 Fax: - - Over 50 hp/1,750 BTU 5104.50 $
E-mail: (3R o6Le3I'!74 a R• L co...., Incinerators
Domestic incinerator $22.50 I $
CCB license no.: 171 704 Commercial
Print name: 6g, lee)6 ER 5 Enter total valuation of mechanical system
and installation costs$
Signature: Enter fee based on valuation of mechanical system,etc. $
Miscellaneous fees items Cost Total
ea. cost
Reinspection $80.00 $
Specially requested inspections(per hr.) $80.00 $
Regulated equipment(unclassed) $14.50 $
Each additional inspection:(1) $80.00 $
APPLICANT USE
(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]) $
440-2545 4(4/I/2013/COM) TOTAL fees and surcharges(A through E): - $