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Permit Mechanical 2014-3-31
• SPRINGFIELD--' 225 Fifth St CITY OF SPRINGFIELD Springfield,OR97477 i� Phone: 541-726-3753 LILT& OREGON Building I Residential Permit Inspection Phone: 541-726-3769 • Fax: 541-726-3676 PERMIT NO: 811-SPR2014-00686 www.Springfield-or.gov perm itcenter@springfiel d-or.gov • PROJECT STATUS: Issued ISSUED: 03/31/2014 EXPIRES: 09/27/2014 STATUS DATE: 03/31/2014 APPLIED: 03/31/2014 SITE ADDRESS: 1171 1/2 HARLOW RD 1,Springfield,OR 97477 SCOPE: Mechanical Only ASSESOR'S PARCEL NO: 1703272200600 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Heat pump OWNER: BAKER MICHAEL P Phone Number: ADDRESS: 2920 COUNTY FARM RD EUGENE OR 97408 CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone Mechanical Contractor PERFORMANCE HEATING 8 COOLING INC CCB 188809 12/01/2015 541-895-4801 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. 3'3/ Owner or 'ontractor Signature Date ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001- wpRK 0090. You may obtain copies of the rules by NOTICE: IRE Ip THE calling the center. (Note: the telephone THIS PERMIT SHAER E. PERMIT is NOT number for the Oregon Utility Notification DAB. OD F Center is 1-800-332-2344). AUTHORIZED OR IS A OR • CO�ip4ENCED ANY 180 DAY PERIOD. Springfield Building Permit 3/31/2014 11:09:10AM Page 1 of 1 • • • • • SPRINGFIELD CITY OF SPRINGFIELD r 225 Fifth St ' L EGOR TRANSACTION RECEIPT Springfield.OR 97477 541-726-3753 811-SPR2014-00686 www.springfeld-or.gov 1171 1/2 HARLOW RD 1 permitcenter @springfield-ocgav RECEIPT NO: 2014000691 RECORD NO: 811-5PR2014-00686 DATE:03/31/2014 ACCOUNT CODE/TRANS CODE__ -_ . - .._;AMOUNT DUE, 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 LIPAyMEN1ITY, __PAYOR CASHIER_CCARPINTJR__.__COMMENTS- - _ _ AMOUNT PAID_ ti Credit Card PERFORMANCE HEATING&COOLIP 93.60 012107 INC • TOTAL PAID: 93.60 • • • • Mechanical Permit Application DEPARTMENT USE ONLY ,,,.. SPRINGFIELD ^si" Sze_'•. s M mss*) ° - Permit no.'. �; O SPI2i GFTELD, ®1KEGU 5 — 6 225 Filth Street • Springfield.OR 97477 s PH(541)726 3753 • FAX(541)726-3689 ° .` OREGON Date: 3 / 1 / �,7 1 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 ISO days. CATEGORY OF CONSTRUCTION FEE SCHEDULE gg Residential El Government El Commercial Residential Qty. cost Total ea. cost JOB SITE INFORMATION AND LOCATION First Appliance 7 580.00 $,0 ' f�iry//w�� Furnace/burner including ducts and vents Job site address: /7 7� � City: �,priA, (j / Up to look R'fUlhr. $10.50 J 5 6' �r/ State: ZIP: 97 7 2 Over 100k 13'fU/hr. $22.00 $ Reference: /a) 272-2-- I Tax lot.:dc7C�OU -- — Floaters/stoves/vents DESCRIPTION OF WORK Unit heater $18.50 $ (477-r- / c4-iv-.y Wood/pellet/gas stove/flue $42.00 S Repair/alter/add to heating appliance/ refrigeration unit or cooling system/ $80.00 S PROPERTY OWNER . absorption system Name: ,-H SIGG C & le✓ Evaporated cooler $14.50 S / Vent fan with one duct/appliance vent $10.00 $ Address: /17/ /a /ryr/.,, Flood with exhaust and duct $14.50 $ _ City: —/,,y rg State: ore ZIP: /p 2) Flour furnace including vent $80.00 S Phone: - Fax: - - Cas.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 duets - requirements under ORS 701.010. Up to 10.000 CEM $12.00 $ Signature: Over 10,000 CFO $22.00 $ CONTRACTOR INSTALLATION Compressor/absorption system/heat pump rr �/ / Up to 3 hp/100k BTU 518.50 $ Nosiness name: Per 'furM<<c /7 tcs//��y ���aJ Ibr l Ip to I hp/500k BTU $32.00 $ Address: /y3— ///. �//Sfcc AMX 7;eU64 175— --- - -. — Up lu 3(1 hp/LOUD Ill ll $47.50 S City: (-tries-€:77 _ __ _. State: Off( ZIP: 97©�� l Ip to 50 hp/1.750 BTU $62.50 $ Phone:s4(-05= (7 S..-0/ Fax:SV/- 03-- 5/5G.7 Over 50 hp/1.750 BTU $104.50 $ Iii-mail: / `/c ,4,,,,a,,, , aa/re-An -- — Incinerators Domestic incinerator $22.50 S CCB license no.: /£'1 bc- 27 Commercial Print name: 5,_ia,r 674u-ea Enter total valuation of mechanical system and installation costs$ Signature: . ; 1.- . —....-._ -----.-- Enter fee based on valuation of mechanical system.etc. S Miscellaneous fees Items Cost Toth' ra. cost Reinspection $80.00 $ Specially requested inspections(per hr,) $80.00 $ Regulated equipment(unclassed) $14.50 $ Each additional inspection: (I) $80.00 $ APPLICANT USE (A) Enter subtotal of above fees(or enter set Go minimum fee of $80.00) $ r)'� (B) Investigative fee(equal to(Al) S /� (C) Enter 12%surcharge 1.12 x IA+Hl) $ 6( f (D)Seismic fee. I%(.01 x [AI) $ (I )Technology Fee(5"%of[All $ ?ED 440-2 2545-I(4/I/2013/COibtt TOTAL fees and surcharges (A through E): $ /3.65