HomeMy WebLinkAboutPermit Mechanical 2014-3-20 SPRINGFIELD 225 Fifth St
CITY OF SPRINGFIELD Springfield,OR 97477
L.11 Phone:541-726-3753
OREGON Building I Commercial Permit Inspection Phone:541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2014-00591
www.springfield-or.gav permitcenter @springfield-or.gov
PROJECT STATUS: Issued ISSUED: 03/20/2014 EXPIRES: 09/16/2014
STATUS DATE: 03/20/2014 APPLIED: 03/20/2014 •
SITE ADDRESS: 1001 MAIN ST,Springfield,OR 97477 SCOPE: Heating System
ASSESOR'S PARCEL NO: 1703354105300 TYPE OF STRUCTURE: Public
PROJECT DESCRIPTION: Ductless heat pump
OWNER: SPRINGFIELD UTILITY BOARD Phone Number:
ADDRESS: 250 A ST
SPRINGFIELD OR 97477
CONTRACTOR INFORMATION
Contractor Type Contractor Name Lic Type • Lic No Lic Exp Phone
Mechanical Contractor ALPINE HEATING LLC CCB 193586 04/01/2015 541-954-9959
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 at the front of the property, and the approved set of plans will remain on the site at all times during
construction.
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Owner or Contractor Signature Date
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ATTENTION: 0legon law requires you to
NOTICES
follow rules adopted by the Oregon Utility THIS PERMIT SHALL EXPIRE IF THE WORK
in OAR 952-001-0010 tthough OAR 9`2 001- COMMENZED UNDER THIS PERMIT IS NOT
through GED 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 1-800-3322344).
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Springfield Building Permit 3/20/2014 1:31106PM Page 1 of 1
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SPRINGFIELD CITY OF SPRINGFIELD
to 225 Fifth St
TRANSACTION RECEIPT SFifteI R97477
OREGON 541-726-3753
811-SPR2014-00591
www.springfield-or.gov 1001 MAIN ST permitcenter @springfield-or.gov
RECEIPT NO: 2014000599 RECORD NO:811-SPR2014-00591 DATE:03/20/2014 Th?DESCRIPTION , „.,w P t . -n = * `ACCOUNT CODE/TRANS CODE'm :. ;AMOUNT,DUE
Mechanical Permit fee(based on value of work) 224-00000-425604 1006 110.98
State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 13.32
Technology fee(5%of permit total) 100-00000-425605 2099 5.55
TOTAL DUE: 129.85
LPAYMENT_TYPE - PAYOR' -CASHIER CCARP.ENTER-- -COMMENTS - -.AMOUNT PAID
Credit Card ALPINE HEATING LLC 129.85
033836
TOTAL PAID: 129.85
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Mechanical Permit Application DEPARTMENT USE ONLY
Jurisdiction-name:. airy $-(321f/4Fit.U/ - - - Permit no.: S/Y- St/
. Address: 2._2-S 57* ci Date: .7/20//Gi
Email: Web: . _ -
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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
- • CATEGORY OF:-:CONSTRUGT1ON'- . ,` -. -"FEE- SCHEDULE .. '
❑Residential ❑Government - Commercial �iResidential , - Cost`, Totaf
Qty es cwt
_. JOB SITE INFORMATION;AND`-10CATION Furnace/burner including ducts and vents
Job site address; t op I M - - Up to 100k B77J/br. - S S
!` ' ` Over 100kBTU/hi-. S $.
City:.771;(ip e 1ck State:i7j� ZIP: 7-7
I 1 TI Heaters/stoves/vents .
Subdivision: /707 j c/I Lot no.:O S 7(�'j. ' - - _
-... . Unit heater� .� "' �-
-::;DESCRIIP,,TION,0F,.,IWORK
451St&I( .(-MB I VIP a'U t/lot-t-I f SS . Repair/alter/add to heating appliance/.
refrigeration unit or cooling system/ i. $ • $
• .. )le-o 1 vEy:0 6x5-1 ern - absorption system
P OP, -O ER INSTALLATION ri. "Evaporated cooler $ $
Name:Sc(li C\e'1d L 4. i] 50.84(( Vent fan with one duct/appliance vent .: :S $'
[C 1 J,jri _, ! ` Hood with exhaust and duct $ $ .-
Address: / 1, , ["1 i7� - Floor furnace including vent. $ $.
"City:, `151" S^'.1( State:f� '- ZIP:a)�7.. Gas piping
Phone '-. .1,67 cogs I Fax -lib- tVVS 0 One to four outlets .. $ $
Email:• - - -. - = Additional outlets(each) ., S S
This installation is being made on property owned by me or.a Air handling units,including ducts
member of my immediate family, and is exempt from licensing Up to 10,000 CFM--- - $ S
requirements under ORS 701.010. - - .Over 10,000 CFM -
Signature: - - Compressor/absorption system/heat pump
CONTRACTOR INSTALLATION ,. ' '., v.,e Up to 3 hp/100k BTU. $ S
Business name: A t '11 AP. 44--a-h-$13 - Up to 15 hp/1,00 BTU $ $
Address: fj - Up to 30 hp/l,000 BTU $ $
T �o - T I (` y , Up to 50 hp/1,750 BTU $ $
- . City: C,�tf su`e,i I" State: Q f I ZIP: 1.4-4/4 t. Over 50 hp/1,750 BTU $ .$ "
Phonec9j-qsy 9q,15q I Fax:" - Incinerators '
Email: gIp;v1E\n2l&tl Yi afrtnlii)[ua i'100-WrI Domestic incinerator I I$ $ {
' CCB license no.: �.9 S S C0 VV Cominal valuation Enter total valuation of mechanical system
Print name: i]ssdj ;,�c j1: . ,. :and,a •atlation costs$ ):VVG - - - -
Signature: - Enter fee based on valuation Tofmechanical system,etc. $ 1107Q
� _ 'Miscellaneous fees Items COSr:c "Total
-: Specially requested inspections(per hr.) ' S S.
Regulated equipment(unclassed): -$- $
APPLICANT- USE r, y„
,' �(A)Enter subtotal of above fees(or enter set
ea.
. '! (B)Investigative fee i :'.S ":
I !(D)Seismic fee, l%(.01 x[A]) ^;7,1]E S
_ TOTAL fees and surcharges(A+B+C+D+E) ::"S, /}1:.1.........---:
to
J :
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