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HomeMy WebLinkAboutPermit Mechanical 2014-4-9 • • SPRINGFIELD - 225 Fifth St `' CITY OF SPRINGFIELD Springfield,OR 97477 (`LA," 541-726-3753 ` OREGON Building / Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2014-00748 • www.springfield-or.gov permitcenter @ springfield-or.gov PROJECT STATUS: Issued ISSUED: 04/09/2014 EXPIRES: 10/06/2014 STATUS DATE: 04/09/2014 APPLIED: 04/08/2014 SITE ADDRESS: 875 57TH ST,Springfield,OR 97478 SCOPE: Mechanical Only ASSESOR'S PARCEL NO: 1702331100700 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: M-Permits for addition built by prior owner without permits OWNER: SMITH JUDITH L Phone Number: ADDRESS: 875 57TH ST . SPRINGFIELD OR 97478 CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone Electrical Contractor REVOLUTION ELECTRIC INC COB 179066 10/30/2015 541-505-8351 General Contractor KAMINSKI CONSTRUCTION LLC CCB 181022 03/22/2016 541-554-9465 Mechanical Contractor KAMINSKI CONSTRUCTION LLC CCB 181022 03/22/2016 541-554-9465 Plumbing Contractor DUSTIN JACK DAWSON CCB 194394 06/28/2015 541-953-8760 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. • -__� -/ 9 / Owner or Contractor Signature ,ate ATTENTION: Oregon law requires you to NOTICE: follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001- THIS PERMIT SHALL EXPIRE IF THE-WORK 0090. You may obtain copies of the rules by AUTHORIZED UNDER THIS PERMIT IS NOT calling the center. (Note: the telephone COMMENCED OR IS ABANDONED FOR number for the Oregon Utility Notification ANY 180 DAY PERIOD. Center is 1-800-332-2344). • Springfield Building Permit 4/9/2014 11:05:42AM Page 1 of 1 SPRINGFIELD CITY OF SPRINGFIELD 225 Fifty St ( � ; TRANSACTION RECEIPT Spring/ieIQ — OR 97477 ?� 541-726-3753 OREGON 811-SPR2014-00748 www.spill19(1516-or.gov 875 57TH ST permitcentergspringfield-or.gov RECEIPT NO: 2014000764, RECORD NO: 811-SPR2014-00748 DATE:04/09/2014 {DESCRIPTION - __ ! _ _ L. 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 I _PAYMENT TYPE_____PAYOR___CASHIER:ccARPENTER ___ _COMMENTS-=-_._:_ - AMOUNT PAID___ _.. Credit Card KAMINSKI CONSTRUCTION LLC _L.__93.60 05366j TOTAL PAID: 93.60 • PliZechanical Permit Application DEPARTMENT USE ONLY ... rr, :i s i.4 .�`p'+xS + "A^-{r�. .rr.nR� r ., - SPRINGFIELD, cLU [ �� p :.:— S/�0079'? sota"4'i4r , i . .+� 0 e "GP's, jj--z Permit no.: /'2i Filth Street • Spnnfreid OR 97477 e I H(i41)726 3753 e FAX(541)726-3689 689 cr r r°'' / U �U �.J �_.__.OREGON Date: 7`7 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 FEE SCHEDULE pResidential I ❑Government Residential Qty, ❑Commercial Cost Total JOB SITE INFORMATION AND LOCATION ea. cost First Appliance $80.00 $eY2)1 Job site address: S76" S7 M Si Furnace/burner including ducts and vents City:SP 44/9 (State:OR I ZIP: 77y Up to 1001: 13TU/hr. $18.50 $ Reference: Over 100k B-f(1/hr. 1-- $22.001 $ 'I'axlot.: DESCRIPTION OF WORK Heaters/stoves/rents / / 1 / /� Unit heater $18.50 $ �:sn Exi.t.g/ Veet k Wood/pellet/gas stove/flue $42.00 S ,_ Repair/alter/add to heating appliance/ refrigeration unit or cooling system/ $80.00 S PROPERTY OWNER \ ` absorptionssteni Name: r// Evaporated cooler $14.50 $ Address: STS 7 71/1 Vent fan with one duct/appliance vent $10.00 $ City: Hood with exhaust and duct $14.50 $ State: A I ZIP: 975/7 — -- ---- tlom furnace including vent $80.00 $ Phone: 57- !/600 Fax: - - Gas P'P' - E-ntailL.)15..,% cS ne to four outlets iYl...i - co COr) $7.50 $ This installation is being ma 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 CPM $12.00 Signature: Over 10.000 CRb1 $22.00 l .$ $ CONTRACTOR INSTALLATION Compressor/absorption system/heat pump Business name: �� ia cAr / !/ use,- i Up l0 3 hp/100k I)-I'U $18.50 $ aMin +a,G i G-G�l/ Address: 875/35/ Alain pto I$hp/lO of BTU $47.00 $ °� Up to 30 hp/1.000 IMI City: a - S62.50 $ ��� Slate: ©� ZIP: I Z-. Up to 50 hp/1.750 BTU S62.50 $ Phone 0919y� Fax:SW/-?3,4:SSW Over 50 hp/1.750 BTU $104.50 $ E-mail: / 1' / Incinerators --S Gehl _L'irteC nat'L'.y�1 CCB license no.: jS/OZ 7._ l(�•// Domestic incinerator I I $22.50 H F --- i i Commercial ...: „,.$0,,i Print name: ...: „,.$0,,i .� Enter total valuation ofinechanical system Signature: _ and installation costs$ � � — ' Enter fee based on valuation of mechanical system.etc. S Miscellaneous fees 1101 1 Cost Total Cost cost Reinspection $80.00 $ Specially requested inspections(per hr.) $80.00 $ Regulated equipment(unclassed) $14.50 $ Each additional inspection:(I) S80.00 S APPLICANT USE .(A)Enter subtotal of above fees(or enter set minimum fee of $80.00) .5g/ (B) Investigative fee(equal to[Al) $ (C)Enter 12%surcharge(.12 x I'A+BI) $ A (D)Seismic fee. 1%(.01 x [A)) $ (E)Technology Fee(5%of[AJ) $ in '_i45-1(4/I/'_013/C'O�II TOTAL fees and surcharges(A through E): S 9 7 4 140-