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HomeMy WebLinkAboutPermit Mechanical 2014-4-22 1. • - SPRINGFIELD 225 Fifth St CITY OF SPRINGFIELD Springfield,OR 97477 t '= Phone: 541-726-3753 OREGON Building/ Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2014-00869- 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: 542 33RD ST,Springfield,OR 97478 SCOPE: Mechanical Only ASSESOR'S PARCEL NO: 1702312404900 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Gas Water Heater OWNER: LABORN TIMOTHY J Phone Number: ADDRESS: 542 33ND ST • SPRINGFIELD OR 97478 CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone Mechanical Contractor BAXTER PLUMBING&ROOTER INC CCB 194034 06/14/2015 541-334-6696 INSPECTIONS REQUIRED • - Inspections - 2255 Gas Pressure Test 2300 Rough Mechanical Rough Mechanical: Prior to Cover 2310 Rough Gas Rough Gas: After line is installed and required testing and capped if not attached to • an appliance. 2995 Final Gas Final Gas: When all gas work is complete. 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. i / • ,)-3 -iy Owner or Cont 1.r Signature Date • • PTT:NTION: Oregon law requires you to !cib;w ruses adopted by the Oregon Utility NOTICE: wct `ication Center. Those rules are set forth • 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 8:19:08AM Page 1 of 1 SPRINGFIELD" -- CITY OF SPRINGFIELD 225 Fifth St TRANSACTION RECEIPT Spnngfield,OR 97477 OREGON 541-726-3753 811-SPR2014-00869 www.springfield-or.gov 542 33RD ST permitcenter©springfield-or.gov RECEIPT NO: 2014000876 RECORD NO: 811-SPR2014-00869 DATE:04/22/2014 e P O I Esf '-( _t - °�;,- `' rt pm:pe: ` -7; 4:3:a mArcal ACCOUNT=CODE(TRANS;CODE.s:,:.Lt AMOUNTIDUE ,F First Appliance Fee 224-00000-425604 1006 80.00 Gas Piping up to 4 outlets 224-00000-425604 1006 7.50 State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 10.50 Technology fee(5%of permit total) 100-00000-425605 2099 4.38 r�r-^ TOTAL DUE: 102.38 pyRAYMEN- TiYP,E PAYOR casNiEinaiiSON- COMMENTS. MOUNTXPAID Credit Card BAXTER PLUMBING &ROOTER INC 102.38 014612 TOTAL PAID: 102.38 Mechanical Permit Application DEPARTMENT USE ONLY SPRINGFIELD G.I M OF sla NGFIE•LD 0 GON Permit no.: rezaY ace 67 225 Fifth Street Springfield.OR 97477 PH(941)726 3713 fAA(541)726•+689 ! ''S.617 ONEGON Date: //Z��!y 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 -Residential ❑Government ❑ Commercial Residential Qty. Cost Total en. cost JOB SITE INFORMATION AND LOCATION First Appliance $80.00 $ Job site address: y 3 3 set-- Furnace/burner including ducts and vents _ _ City js 4.1 State: ZIP: Up to 100k BTU/hr. $10.50 Over 100k 13'f11/hr. $22.00 $ Refer ice: 0 Taxlot.: — I-leaters/stoves/vents DESCRIPTION OF WORK Unit heater 7, $18.50 (2 S • /r Wood/pellet/gas stove/flue $42.00 $� r Repair/alter/add to heating appliance/ refrigeration unit or cooling system! $80.00 S PRO'/ RTY OWNER absorption system Name: 44'h 4_n fr%, Evaporated cooler $14.50 $ Address: Vent fan with one duct/appliance vent $10.00 $ --33 Hood o�ith exhaust and duct 514.50 S City: ��� /� Stat :'.. - ZIPt�%L�7 V. Floor furnace including vent $80.00 $ Phone:VJY" - Pax: - - f �� n Gas piping _� F-mail: --- One to four outlets $7.50 $70 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 10.0011 CFM $12.00 $ Signature: ) Over 10.000 CENT S22.00 $ CONTRACTOR INSTALLATION Compressor/absorption system/heat pump Business name. -}zo,r turn p,A Up to 3 hp/ 00k BTU $32.x0 9 Up to 15 hp/500k BTU $32.00 $ Address: Up to 3t)hp/I,000 BTU $47.50 $ Cil{/ , - State . / fl3 ZIFL`�?/j? Up to 50 hp/1.750 BTU $62.50 $ Phoncel/e 64 yG Fax: - - _,..- Over 50 h1)/1.750 BTU $104.50 $ E-mail. /77,p ce,'Je oil-Pr-gun] G/ A h �y,� Incinerators ___ CCB license no.: 90� Y 7T Domestic incinerator $22.50 $ ----- Commercial Sim ------..__---._-..___._ Print name: Enter total valuation of mechanical system �C and installation costs$ Signature: -- Enter fee based on valuation of mechanical system.etc. S Miscellaneous fees Items Cost Toed ca. cost • Reinspeetion $80.00 $ Specially requested inspections(per hr.) $80.00 $ Regulated equipment(unelassed) $14.50 $ Loch additional inspection: (I) $80.00 $ APPLICANT USE (A)Enter subtotal ofabove lees(or enter set —0 minimum fee of $80.00) $<67 i (B) Investigative fee(equal to[Al) $ (C) Enter 12%surcharge(.12 x IA+131) $ /V (0)Seismic fee. I%(.01 x [A]) $ ' (F)Technology Fee(5%of[Al) $ 4 0-/ 140-2545-1(a/112013/COMt 'TOTAL fees and surcharges(A through E): $ /0Z