HomeMy WebLinkAboutPermit Mechanical 2014-4-22 SPRINGFIELD 225 Fifth St
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_A CITY OF SPRINGFIELD Springfield,OR 97477
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Phone: 541-726-3753
OREGON Building / Residential Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2014-00878
www.springfield-or.gov permitcenter @springfield-or.gov
PROJECT STATUS: Issued ISSUED: 04/22/2014 EXPIRES: 10/19/2014
STATUS DATE: 04/22/2014 APPLIED: 04/22/2014 •
SITE ADDRESS: 225 12TH ST,Springfield,OR 97477 SCOPE: Mechanical Only
ASSESOR'S PARCEL NO: 1703354100400 TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION: Ductless HP&2 bath fans
OWNER: CROWELL SCOTT M Phone Number:
ADDRESS: 225 12TH ST •
SPRINGFIELD OR 97477
CONTRACTOR INFORMATION •
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
Mechanical Contractor NEIL KELLY CO INC CCB 1663 12/09/2014 503-288-7461
L INSPECTIONS REQUIRED III
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.
kt1(2.21_, \--j?,i j ' A Ul A .
Owner or Contractor Signature Date •
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ATTENTION: Oregon law requires you to
follow rules adopted by the Oregon Utility
NOTICE: Notification Center. Those rules are set forth
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THIS PERMIT SHALL EXPIRE IF THE WORK in OAR 952-001-0010 through OAR 952-001-
AUTHORIZED UNDER THIS PERMIT IS NOT 0090. You may obtain copies of the rules by
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 4/22/2014 11:53:14AM Page 1 of 1
SPRINGFIELD CITY OF SPRINGFIELD
ry'1' ... 225 Fifth St
`� TRANSACTION RECEIPT Springfeld,OR97477
.OREGON 541-726-3753
811-SP R2014-00878
wvrw.sphngfield-or.gov 225 12TH ST permitcenter @springfield-cr.gov
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RECEIPT NO: 2014000887 RECORD NO: 811SPR2014.00878 DATE:04/22/2014
{e1 g • d ill , ':e,r-t3'. !a{ .-.x.?.- .� - ;: ,,'L;-a'c.'ACCOUNT;CODE/TRANS:CODE SVa7AMOUNT DUES/
First Appliance Fee 224-00000-425604 1006 80.00
Single-duct exhaust(bathrooms, toilet compartments, utility room: 224-00000-425604 1006 20.00
State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 • 12.00
Technology fee(5%of permit total) 100-00000-425605 2099 5.00
TOTAL DUE: 117.00
h'°'Pi^nttn PE . t PAYOR ^'.0 A SHIEyCA PENER I >"wOMMENTS. � -s 9- sAMOUNT PAID 2
t `` '
Credit Card Michelle Porhola 117.00
23416b
TOTAL PAID: 117.00
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Mechanical Permit Application DEPARTMENT USE ONLY I
SPRINGFIELD+1W :
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CITY OF SPRINGFIELD, OREGON »� Permitno.: 5I�� O I
225 Filb Street•Springfield,Ott.97477 • PH(541)726-3753 ♦FAX(541)726-3689 `L OREGON Date: co. Z 71 Lit
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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 i
suspended for 180 days. (
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CATEGORY OF CONSTRUCTION FEE SCHEDULE i
El Residential 0 Government I 0 Commercial Residential Qty. Cost Total t., I
ea. cos
JOB SITE INFORMATION AND LOCATION First Appliance / $80.00 $2)--
Job site address: 225 NI 12-Th^Se , Furnace/burner including ducts and vents
City: Spvinv}�T e4 el I State:
BIZ ZIP: Q '�� Up to 100k BTU/hr. $18.50 $
Over 100k BTU/hr. $22.00 $
Reference: Taxlot.:
Heaters/stoves/vents
DESCRIPTION OF WORK Unit heater ..
$18.50 $
I ) do cR4 s s fl i YU-St {if St.[5-1-2 h Wood/pellet/gas stove/flue $42.00 $ I
Repair/alter/add to heating appliance/
' refrigeration unit or cooling system/ $80.00 $ '
PROPERTY OWNER absorption system
Name: C A/er --G Evaporated cooler $14.50 $
Address: 2ZS- /2/41— Vent fan with one duct/appliance vent "1,_ $10.00 $ap
Hood with exhaust and duct $14.50 $
City: State: ZIP: Floor furnace including vent $80.00 $
Phone: 5 -7,Rep" LGo y Fax: - - Gas piping
E-mail: ,,ff / 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 $ fi
CONTRACTOR' INSTALLATION Compressor/absorption system/heat pump
F-P tI�y1,•� (cn% a11t (no , Up to 3 hp/500k BTU / $18.50 $�
Business name: nttl1
""t r 1 Up to 15 hp/500k BTU ( $32.00 $
Address: R04. Ni .1 AI b?rt& 57b . Up to 30 hp/1,000 BTU $47.50. $
City: 1)6 AYvd State:vr< ZIP: 9.4213 Up to 50 hp/1,750 BTU $62.50 $
Phone:so3._2ea,-t46I Fax:50'5-288—; (or} Over 50 hp/1,750 BTU $104.50 $
E-mail: Michelle. orkolo_&vt i[keLILj annA Incinerators
1 Domestic incinerator I I $22.50 I $
CCB license no.: I(o(p 3
Commercial
Print name: bd l cell alle 1Porin o la 541'2314143 cell Enter total valuation of mechanical system
n n and installation costs$
Signature•t at,Qt Y� Enter fee based on valuation of mechanical system,etc. $
��� Miscellaneous fees Items Cost Total
. ea. cost _
Reinspectioa $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 /00 d O
minimum fee of $80_00)
(13)Investigative.fee(equal to[A]) $
(C)Enter 12%surcharge(.12 x[A+13]) $ J2%
(D)Seismic fee, 1%(.01 x[A]) $
. (F.)Technology Fee(5%of[A]) $ /442r iCid
.440-2545-1(4/1/2013/COM) TOTAL fees and surcharges(A through E): $ i //?at)
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