HomeMy WebLinkAboutPermit Mechanical 2014-2-3 SPRINGFIELD 225 Fifth St
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`6CITY OF SPRINGFIELD Springfield,OR 97477
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Phone: 541-726-3753
'' OREGON Building / Residential Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2014-00212
www.springfield-or,gov permitce me r @sprin gfield-ar.gov
PROJECT STATUS: Issued ISSUED: 02/03/2014 EXPIRES: 08/02/2014
STATUS DATE: 02/03/2014 APPLIED: 02/03/2014
SITE ADDRESS: 1429 M ST,Springfield,OR 97477 SCOPE: Mechanical Only
ASSESOR'S PARCEL NO: 1703253303800 TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION: Fire damage repairs
OWNER: SHELTON JENNIFER ERICA - Phone Number:
ADDRESS: 1429 M ST
SPRINGFIELD OR 97477
CONTRACTOR INFORMATION
Contractor Type Contractor Name Lic Type - Lic No Lic Exp Phone
Mechanical Contractor THOMAS MICHAEL MCGINNIS CCB 131887 10/22/2014 541-744-0640
General Contractor THOMAS MICHAEL MCGINNIS CCB 131887 10/22/2014 541-744-0640
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 -t the front of the property, and the approved set of plans will remain on the site at all times during .
construction.
.-..... ) /I 4/
Owner or Contractor Signature Dat /
ATTENTION: Orenon !aw requires you to
NOTICE:
Notification Center.t Those the rules ego Set Utility
THIS PERMIT SHALL EXPIRE IF THE WORK in OAR 952-001-0010 through OAR 952-001-
AUTHORIZED UNDER THIS PERMIT IS NOT 0090. You may obtain copies of the rules by
calling the center. (Note: the telephone
COMMENCED OR IS ABANDONED FOR number for the Oregon Utility Notification
ANY 180 DAY PERIOD. Center is 1-800-3322344),
Springfield Building Permit - 2/3/2014 2:05:02PM Page 1 of 1
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SPRINGFIELD CITY OF SPRINGFIELD
+�i - -
: ( ; TRANSACTION RECEIPT 225 Fifth St
97477
OREGON 541-726-3753
811-S PR2014-00212
www.springfielo-or.gov 1429 M ST permitcenter @springfield-or.gov
RECEIPT NO: 2014000217 RECORD NO:811-SPR2014-00212 DATE:02/03/2014
[DESCRIPTION . • ACCOUNT CODE/TRANS CODE c' - AMOUNT DUE.J
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
,_PAYMENT TYPE PAY-OR "cASHIER:CCARPENTER , COMMENTS - . -.AMOUNT PAID_
Credit Card THOMAS MICHAEL MCGINNIS 93.60
901363
TOTAL PAID: 93.60
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Mechanical Permit Application DEPARTMENT)USE ONLY
^,.. ccieal --xW� 77V, .� ' .y4 ..�t.+ 5PmINGFI EL
ITY O #SPRINGI IELD OREG®N 1 Permit no.:s(y -24 2
xmO hs, .,.a�,u. .ate ...,�_ .Nqv. ,.�.P.43: lids z�i?t�sa�-iis:`a',. st /
225 Fifth Street• Springfield,OR 97477 • PH(54I)726-3753 • FAX(541)726-3689 c 4 Date: Z/1/ / t-!
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.
LY ;� , ,0ATEGORY,KO. . CONSTRUCTIONI„ t t,'1*a j n p / FEE SCHEDULES :S >'
a Cost + Total ;
sResidential ❑ Government ❑ Commercial Resldential,,yti %1,3,,7 as Qh' FZ± ;ea^ v`,- ..„%'cost i•
` ,`JOB jSITE. [NFORMATION AND,fLOeigl01 is 1 First Appliance $80.00 $ tfQ F9'
Job site address: / q f 2 q M 51- Furnace/burner including ducts and vents
City: 5,04 ([5 1)ea State: C R ZIP: 9 7 9 77 Up to 100k BTU/hr. $18.50 $
Over 100k BTU/hr. $22.00 $
Reference:
Taxlot
l Heaters/stoves/vents
, ,z,'y,, .. 4' DESCRIPTIONr:OF€WORKe-SI� 47.1 , Unit heater $18.50 $
We(./ f%a#(1 FA0 Wood/pellet/gas stove/flue $42.00 $
Repair/alter/add to heating appliance/
refrigeration unit or cooling system/ $80.00 $
'a {PROPERTYOWNERaa4f • Wµ
absorption system
Name: Evaporated cooler $14.50 $
��Nrl w�'a✓ a!✓I Vent fan with one duct/appliance vent $10.00 $
Address: 1 Lf 2 M 5 ,,_
Hood with exhaust and duct $14.50 $
City: 5/0/t I d State: 0R. ZIP: /y 71/77 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 $
�` CONTRACTOR=INSTALLATIONjacar Compressor/absorption system/heat um
�' �_.. Fv ._G..n,�P' pump
Up to 3 hp/100k BTU $18.50 $
Business name: /'G&/1/ Qua/%�,/ Can 5f iictai"i PI Up to 15 hp/500k BTU $32.00 $
Address: 3 7 5 / 4 ti v/ ,4,/e Up to 30 hp/1,000 BTU . $47.50 $
City: 5pytg2{ 'e/d State: ek ZIP: 9 r't7p Up to 50 hp/1;750 BTU $62.50 $
Phone: /64{,-75- 07 if( Fax: - - Over 50 hp/1,750 BTU $104.50 $
E-mail: 6 oPtirae -l7✓ rylk 0.mi$ I) , G. 614-7 Incinerators
Domestic incinerator $22.50 $
CCB license no.: / 3/ $.-0-7 rCommefcial rr r ; ` `
Print name: "( ihCNq e/ J1 1 C�tivq _y,
. . Enter total valuation of mechanical system
(-jJL � and r installation
fee a see costs l
Signature: ,,<,,,A9� !�"/ Enter fee based on valuation of mechanical system,etc $
" •' a lei, ^r' :Cost 'Total ,k
Miscellaneous fees Isems -ea• cost
Reinspection $80.00 $
Specially requested inspections(per hr.) $80.00 $
Regulated equipment(unclassed) $14.50. $
Each additional inspection:(I) $80.00 $
ro, , , r APPLItrANTsUSE f SY.e%
(A)Enter subtotal of above fees(or enter set h?f�,
minimum fee of $80.00) $
. (B)Investigative fee(equal to[A]) $
(C)Enter 12%surcharge(.12 x[A=B]) $g
(D)Seismic fee, 1 (.01 x[A]) $ _
(E)Technology Fee(5%of[A]) $/L
440-2545-J(4/1/2013/COM) TOTAL lees and surcharges(A through E): $ a