HomeMy WebLinkAboutPermit Mechanical 2014-2-21 •
SPi'n.1NGFIELD 225 Fifth St
CITY OF SPRINGFIELD Springfield,OR 97477
Phone: 541-726-3753
OREGON Building / Residential Permit Inspection Phone: 541-726-3769
Fax: 5417 726-3676
PERMIT NO: 811-SPR2014-00162
wnw+.springfield-or.gov perm itcenter@a springfield-or.gov
PROJECT STATUS: Issued ISSUED: 02/21/2014 EXPIRES: 08/20/2014
STATUS DATE: 02/21/2014 APPLIED: 01/27/2014
SITE ADDRESS: 868 6TH ST,Springfield,OR 97477 SCOPE: Mechanical Only
ASSESOR'S PARCEL NO: 1703352101200 TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION: Gas fireplace
OWNER: GOOD MARILOU Phone Number:
ADDRESS: 868 6TH ST
SPRINGFIELD OR 97477
CONTRACTOR INFORMATION
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
Mechanical Contractor MICHAEL JAY TURNER CCB 120447 02/20/2016 541-933-2060
INSPECTIONS REQUIRED j
Inspections
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
construction.
Owner or Contractor Signature Date •
ATTENTION: Oregon law requires you to
follow rules adopted by the Oregon Utility
OOId3d At/0 08 L ANV Notification Center. Those rules are set forth
80103NOONVBV SI 80 030N31NW00 in OAR 952-001-0010 through OAR 952-001-
10N SI 1l1/183d SIN! a30Nl 03ZIa0Hlfld 0090. You may obtain copies of the rules by
Na0M3H14I 3UIdX311VHS 111/1F13d SIH1. calling the center. (Note: the telephone
�30110N • number for the Oregon Utility Notification
. Center is 1-800-332-2344). •
Springfield Building Permit 2/21/2014 2:00:12PM Page 1 of 1
SPTINGFIELD • - CITY OF SPRINGFIELD
TRANSACTION RECEIPT Spnngfeld.OR 97477
a �O REGO N 541-726-3753
811-SP R2014-00162
www.springfield-or.gov 868 6TH ST permitcenter @spnngfield-or.gov
RECEIPT NO: 2014000381 RECORD NO: 811-SPR2014-00162 DATE: 02/21/2014
DESCRIPTION JAra.,wi. . ;. .'" !'5 C-t.4-„:4 'ACCOUNT-COD /TRANS CODE` ; , if AMOUNT; .1
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
"PAYMENT TIYP_E , P,aDal .. ararliEE ccARee TE ,COMMEN;T.S MOUNT4'P,AI_D, -
Credit Card GOOD MARILOU 102.38
00965d
TOTAL PAID: 102.38
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Mechanical Permit Application DEPARTMENT,USE ONLY _
_; {- yy p ,� SPRINGFIELD
t CITY' OP�" RINGEIELD4P REGONr • -e Permit no C 114— )(t/Z
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 t ` l;' 4" ,, „n giti 3#FEE SCHEDULE , x 1 y ,,:x3
)(Residential ❑ Government El Commercial Residential,. ki:', '``K ' ' Cost Total >.
o < ,r1 �_ x . QtY v'eaL ..J;cost x
r: S;- JOB SITE INFORMATION ,ANDtiIrOI --CATION.;: T First Appliance / $80.00 $ �d
Job site address: I tag 9y-el- r ` Furnace/burner including ducts and vents
City: vnC L IG State: O12-- ZIP: 7 u7-3 Up to IOOk BTU/hr. $18.50 $
I Over 100k BTU/hr. $22.00 $
Reference Taxlot
3-�:k,a a , , �p .nn%, Heaters/stoves/vents
nc� _�Ne$1C 1.0:1-ON _0- WORK:ai _ „ZIk Unit heater $18.50 $
i
�Ciss5 1 co o `----- (2 Wood/pellet/gas stove/flue f $42.00 $.^,'�. Repair/alter/add to heating appliance/
refrigeration unit or cooling system/ $80.00 $
t i!k(' l s -treP1ROPERTy OWNER " �", g„ '„;Rh'`„"'_`, absorption system
Name: Mat'c l Q h (=1771) Evaporated cooler $14.50 $
Address: <( I' 10-1- re t-( Vent fan with one duct/appliance vent $10.00 $
//II Hood with exhaust and duct $14.50 $
City: .n fr e. (1 State: 0 2 ZIP: I a-q 7� Floor furnace including vent $80.00 $
Phone �t(11.53�-7- Fax: - - Gas piping
E-mai t'pea rra.J-C 6'p th O O .CgD Y', . One to four outlets $7.50 $
This ' st cation is being ma e n property. owned by me or a Additional outlets(each) $4.50 $
membe f my immediate fami y, and is exempt from licensing Air-handling units,including ducts
requirements under ORS 701.0I0. Up to 10,000 CFM $12.00 $
Signature^ �'' p—iL � Over 10,000 CFM $22.00 $
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