HomeMy WebLinkAboutPermit Mechanical 2014-3-26 1r
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SPRINGFIELD
225 Fifth St
CITY OF SPRINGFIELD Springfield,OR 97477
` • Phone: 541-726-3753
OREGON Building I Commercial Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2014-00635
www.springfield-or.gov permitcenter @springfeld-or.gov
• PROJECT STATUS: Issued ISSUED: 03/26/2014 EXPIRES: 09/22/2014
STATUS DATE: 03/26/2014 APPLIED: 03/26/2014
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SITE ADDRESS: 1040 GATEWAY LOOP,Springfield,OR 97477 SCOPE: Mechanical Only
ASSESOR'S PARCEL NO: 1703222002402 TYPE OF STRUCTURE: Commercial
• PROJECT DESCRIPTION: M-Tenant infill for dentist office
OWNER: NECA-OREGON-PACIFIC-CASCADE CHAPTER • Phone Number:
ADDRESS: 1040 GATEWAY LOOP STE A
SPRINGFIELD OR 97477
CONTRACTOR INFORMATION
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
Mechanical Contractor INNOVATIVE AIR INC CCB 161742 10/11/2014 541-746-1040
General Contractor MCINTYRE CONSTRUCTION INC CCB 3550 10/08/2015 541-687-2841
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 ins.-ctions are requested at the proper time, that each address is readable from the street, that the
permit card is located at th.- `rant of the property,and the approved set of plans will remain on the site at all times during
construction
AZ(7 YIValle C7'2 g V(7
Owner or Contract• .Signature Date•
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ATTENTION: Oregon law requires you to
follow rules adopted by the Oregon Utility
K Notification Center. Those rules are set forth
0flT10E VOA_EXPIRE
IF THE wU OT n OAR 952-001-0010 through OAR 952 001•
THIS PERMIT THIS PERM(T �S N 0090. You may obtain copies of the rules by
D UNDER ONE0 FOR calling the center. (Note: the telephone` •
pUTNORiZE. OR IS pSAND number for the Oregon Utility Notification
.0MN1ENpPp PERIOD. Center is 1-800-332-2344).
IY1S0
Springfield Building Permit 3/26/2014 1:53:32PM Page 1 of 1
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SPRINGFIELD -- CITY OF SPRINGFIELD
225 Fifth St
r GoN TRANSACTION RECEIPT Springfield,OR97477
Lett 541-726-3753
811-SPR2014-00635
www.springfieldor.gov 1040 GATEWAY LOOP permitcenter @springfield-or.gov.
RECEIPT NO: 2014000655 RECORD NO:811SPR2014.00635 DATE:03/26/2014
o SC" 10'7)11 '-1" t,_. _:',ate.. `:"tom -.,.a :» _'iACCOUNTdCODE/TRANSTCODEf.'aT6_y1F1'AMOUNTiDUEr
Mechanical Permit fee(based on value of work) 224-00000-425604 1006 224.56
State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 26.95
Technology fee(5%of permit total) 100-00000-425605 2099 11.23
TOTAL DUE: 262.74
`PA.YMENTTYPE.L:"'P.AYOR'"=_cr aER::ULARSON 4i;thd 1 a COMMENTS..tee.,:..!' � ,.'S St-3.`Y� , ,;AMOUNl'�'P LID.,,9 ,�,'r-.:tk,S
Credit Card Charles McClain 262.74
03456g
TOTAL PAID: 262.74
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Mechanical Permit Application DEPARTMENT USE ONLY
,oY" i .. '^ k'�z" fir. SPRINGFIELD
`-CITrYOF SPRINGFI lThi REGO Permit no.: S�y'w
t IC 225 Filth Street • Springfield.OR 97477 • PH(541)726 3753 • FAA(541)726-.3689 , ,OREGON Date: ?racy/y
This permit is issued under OAR 918-440-0050. Permits expire if work is not started within ISO days of issuance or if work is
suspended for 180 days.
CATEGORY OF CONSTRUCTION FEE SCHEDULE
❑ Residential ❑Government Commercial Residential 6.p, Cost Total
ea. cost
JOB SITE INFORMATION AND LOCATION First Appliance $80.00 $
Job site address: /1:2-ID (5 40 u7 - 1-15The Furnace/burner including ducts and vents
City: f M �'{,p Q pP State: r;1L Z.I P:q7//)'� Up to I00k Mill/hr. $18.50 $
_ Over look 13'IU!hr. $22.00 $
• Reference: /73 2z?�D faxlot.: 2444 Heater's/stoves/vents
DESCRIPTION OF WORK Unit heater $18.50 $
rh I ' a ,59614-(1-rbi � Wood/pellet/gas stove/flue $42.00 $
Pti, n i r, A refrigeration ration unit to heating appliance/
R - rcingorntion unit or cooling system/ $80.00 S
1 :RO'ERTY OWNER absorption system
Name: 0-e r A Evaporated cooler $14.50 $
J J Vent fan with one duel/appliance vent $10.00 $
/DLO DLO ( �e„ 6(--Thlra
Hood with exhaust and duct 514.50 S
City: j iirjeti State: CR, I ZIP: 6n-7 Floor furnace including vent $80.00 $
Phone:C 1E 03(,---- /1.)L)3 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 S
member of my immediate family, and is exempt from licensing Air-handling units, including duets
requirements under ORS 701.016. Up to 10,000 CFib1 512.00 $
Signature: Over 10.000 CF\1 $22.00 $
CONTRACTOR INSTALLATION Compressor/absorption system/heal pump
�, Up to 3 hp/1 OOk 131U . $18.50 5
Business name: y-h 0 n i ...}. V.-¢, A, ---
Up to 15 hp/50014 BTU $32.00 $
Address: . Up to 30111)/1,000 I3U $47.50 $
City: State: ZIP: Up to 50 hp/I.750 BTIJ $6230 $
Phone: 71.-{C /Q y0 Fax: - - Over 50 lip/1.750 BTU $104.50 $ __
F-mail: Incinerators _
Domestic incinerator I I $22.50 I S
CCB license no.: /�( �l� L _ —
1 Commercial
Print name: Enter total valuation ofineeljnnical system
and installation costs$ /')
Signature: Enter fee based on valuation of mechanical system.etc. $ 2-V 5C.°
Miscellaneous fees Item Cost Total
ea. _ cost
Reinspectioit $80.00 $
Specially requested inspections(per hr.) $80.00 $
Regulated equipment(unelnssed) $14.50 $
Each additional inspection: (1) $80.00 $
APPLICANT USE
(A) Enter subtotal of above fees(or enter set ��
minimum fee of $80.00) $ 2
(13) Investigative tee(equal to I Al) _ $
(C) Enter 12%surcharge(.12 x IA+B]) $ 20`75.
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(D) Seismic fee. 1%(.01 x(A]) .$
(F)Technology Fee(5%of[A]) $ (/ 2:1-
440-2545-1(4/1/2013/COED 'TOTAL fees and surcharges(A through E): S 747