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HomeMy WebLinkAboutPermit Mechanical 2014-3-3 SPRINGFIELD , _ 225 Fifth St ` -t a CITY OF SPRINGFIELD Springfield,OR 97477 (\ 97477 Phone: 541-726-3753 — ` OREGON Building / Commercial Permit Inspection Phone: 541-726-3769 . Fax: 541-726-3676 PERMIT NO: 811-SPR2014-00462 www.springfield-or.gov permitce nter @springfield-or.goy PROJECT STATUS: Issued ISSUED: 03/03/2014 EXPIRES: 08/30/2014 STATUS DATE: 03/03/2014 APPLIED: 03/03/2014 SITE ADDRESS: 1865 OLYMPIC ST,Springfield,OR 97477 SCOPE: Mechanical Only ASSESOR'S PARCEL NO: 1703253107400 TYPE OF STRUCTURE: Commercial PROJECT DESCRIPTION: Mechanical for tenant infill OWNER: NADINE L BURGE EXEMPT MARITAL TRUST Phone Number: ADDRESS: 830 MCKENZIE CREST DR SPRINGFIELD OR 97477 CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone Mechanical Contractor KENT WITHAM AIR INC CCB 189283 01/20/2016 541-543-6580 INSPECTIONS REQUIRED II Inspections 2300 Rough Mechanical Rough Mechanical: Prior to Cover • 2925 Consultation Mechanical 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 constructtiion., / L EA /rr ,377A/ Owner or Contractor Signature Date • NOTICE: ATTENTION: Oregon law requires you to THIS PERMIT SHALL EXPIRE IF THE WORK follow rules adopted Those oye rules are set Notification Center. Those rules are set forth AUTHORIZED UNDER THIS PERMIT IS NOT in OAR 952-001-0010 through OAR 952-001- COMMENCED OR IS ABANDONED FOR 0090. You may obtain copies of the rules by ANY 180 DAY PERIOD. calling the center. (Note: the telephone number for the Oregon Utility Notification Center is 1-800-332-2344). Springfield Building Permit 3/3/2014 2:32:37PM Page 1 of 1 SPRINGFIELD CITY OF SPRINGFIELD 225 Fitth St { ��, TRANSACTION RECEIPT Springfield,OR97477 OREGON 541-726-3753 811-SPR2014-00462 www.springfield-or.gov 1865 OLYMPIC ST permitcenter©springfield-or.gov RECEIPT NO: 2014000469 RECORD NO: 811-SPR2014-00462 DATE:03/03/2014 [DESCRIPTION -- ACCOUNT-CODE/TRANS CODE. ra.._AMOUNT;DUE ,S Mechanical Permit fee(based on value of work) 224-00000-425604 1006 356.33 State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 42.76 Technology fee(5%of permit total) 100-00000-425605 2099 • 17.82 TOTAL DUE: 416.91 L_PAYMENT TYPE _ PAYOR CASHIER:ccARPENTER .. 'COMMENTS ,. : y:� AMOUNT PAID -,) Check KENT WITHAM AIR INC 416.91 2494 TOTAL PAID:, 416.91 • • • • • Mccha111Cal Permit Application DEPARTMENT,USE ONLY il t !Mt4! * aJ " rV457B - g SPR I"CFI EL ".*"cnet _ '�ITYY OF SPRINGFIELD OREGON i Permit no.:5/4/—. �60 Z si- .., ,ram, .x _ „: ,. ]1 .. r,. n 225 Fifth Street• Springfield,OR 97477 • PH(541)726-3753 • FAX(s41)726-3689 os-r''. at Date: 7/ T7/17 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. " y ',ir;CATEGORY,;=QF ,CONSTRUCTIONS ` „K 7` ,n,+u s , 'I, FEE_SCHEDULE. ,'i r; . /, t,yy ❑Residential ❑Government ,X Commercial Resldentlal ] ,i;,`Alty, --f- -'.a Qty ' Cost ti l Total:? -_. .:;C:.x.- _:. gatac-,... . a ... ea. . ,=9141COSt ..l1 ^—`JOB„SITE INFORMATION': AND ILOCATION ,, k First Appliance $80.00 $ Job site address: 1 8 (p5 ply Yt"l f I C'. Furnace/burner including ducts and vents City:5Prin9FieId. State: OP. ZIP: 97g77 Up to 100k BTU/hr. $18.50 $ Reference: /7o 3 S 7/ Taxlo[v7YOa Over 100k BTU/hr. $22.00 $ 2 Heaters/stoves/vents t., ri '" "- s DESCRIPTION;;OFJ,WORK,e,t ,/ �, ,,;; , v`;, - `— Unit heater $18.50 $ �hbVet \/l?eAt .ce 6c€etSett Hoed `t' L�)CtWd3T Wood/pellet/gas stove/flue . $42.00 $ \ U� ckco C but- 3 \-vtc,T O� I s , Repair/alter/add to heating appliance/ r N d �- refrigeration unit or cooling system/ $80.00 $ 3k t�. ,h ,t7 F'_-'skikiPROPERTY';OWNER ,:tr"i<t.;42,, =,''tr: r, absorption system Name: 'SO.W1-eS V ' 'e, Nt icy/ & Evaporated cooler $14.50 $ Address: DO %'LG/Le�2/C C-/t--Ec i� Vent fan with one duct/appliance vent $10.00 $ Hood with exhaust and duct $14.50 $ City: Se P(__r) State: 0-)� ZIP:9 7Y? Floor furnace including vent $80.00 $ Phone:5'M SID- 1337 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 $ -4 ',z?.1 CONTRACTOR INSTALLATIQN ,;t_<Eg`s1 Compressor/absorption system/heat pump L -1 p Up to 3 hp/100k BTU $18.50 $ Business name: ice,` c9 t A q Ski Up to 15 hp/500k BTU $32.00 $ Address: 7b Boy 1758' $frincc[(la Up to 30 hp/1,000 BTU $47.50 $ City: ,SP6h ci e a State: OF_ II{ ZIP: ?7 977 Up to 50 hp/1,750 BTU $62.50 $ PhoneSit 5 - (o586 Fax:Sth 4p - 9 1 6 Over 50 hp/1,750 BTU- $104.50 $ E-mail: K1x) ctc 0 of 19 HA-wick Il , COVt Incinerators /8qz$ Domestic incinerator $22.50 $ CCB llCenSe no.: , of y r ,.,., x:r. ;Commercial „sa�,.tr�+_ , rnl1 ,r 3 °v ,�• ,1 Print name: R ph— ( Aeon Enter total valuation of mechanical system M1 / I and installation costs$ �i c' Signature: - — t >g- Enter fee based on valuation of mechanical system,etc $�.r( I :N M iscellaneous fees,yy 4 r I•tems =cost Total 33� .� -r,,. ter. , ea `'cost Reinspection $80.00 $ Specially requested inspections(per hr.) $80.00 $ Regulated equipment(unclassed) $14.50. $ Each additional inspection: (1) $80.00 $ S t ni APPLICANT;USE, >tt 1t (A)Enter subtotal of above fees(or enter set �_i.77 minimum fee of $80_00) $ V (B)Investigative fee(equal to[A]) $ (C)Enter 12%surcharge(.12 x[A+B]) $ j/2-7�- (D)Seismic fee, 1%(.01 x[A]) $ (E)Technology Fee(5%of[AD $ (78Z 440-2545-1(4/1/2013/COM) TOTAL fees and surcharges (A through E): 1 $If! 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