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Permit Mechanical 2014-4-18
• SPRINGFIELD 225 Fifth St ________isi At CITY OF SPRINGFIELD Springfield,OR 97477 Phone: 541-726-3753 '`- .OREGON Building / Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2014-00857 www.springfield-or.gav permitcenter @springfield-or gov PROJECT STATUS: Issued ISSUED: 04/18/2014 EXPIRES: 10/15/2014 STATUS DATE: 04/18/2014 APPLIED: 04/18/2014 SITE ADDRESS: 975 6TH ST,Springfield,OR 97477 SCOPE: Mechanical Only ASSESOR'S PARCEL NO: 1703351204500 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: ME-Bath fans OWNER: RINEHOLD NAOMI Phone Number: ADDRESS: PO BOX 1146 CAVE JUNCTION OR 97523 OWNER: SAMUEL HOBBS Phone Number: 458-205-1766 ADDRESS: 975 6th Street SPRINGFIELD OR 97477 CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone General Contractor OWNER GCB 000000 08/01/2025 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. Owner or Contractor Signature Date Springfield Building Permit 4/18/2014 2:21:52PM Page 1 of 1 SPRINGFIELD - k CITY OF SPRINGFIELD 4 4 ++b. 225 Fifth St ,. TRANSACTION RECEIPT Springfield,OR 97477 �N 541-726-3753 OREGON 811-SPR2014-00857 www.springfield-ar.gov 975 6TH ST permitcenter©springfield-or.gov RECEIPT NO: 2014000866 RECORD NO: B11-SPR2014-00857 DATE:04/18/2014 i DESCRIPTION ., .,. ;_:_:;._ ;_._ u=. ;ACCOUNTCODE/TRANS:CODE _` -_.m!._AMOUNT'DUE_ 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 L PAYMENT TYPE . , PAYOR_ .CASHIER:CCARPENTER • ;COMMENTS_____-____— -'». AMOUNT PAID ___j Check — �� SAMUEL HOBBS------ — ----- - --- - _--__—~- 117.00-:__.--___ TOTAL PAID: 117.00 • • • • • Mechanical Permit Application DEPARTMENT USE ONLY ;; /, . r 4,. ., .,,.,tics _w .a SPRINGfIELO tCITY OO F SPRINGF ELD, OREGON '` '�� Permit no ,S/ - 7 :e �y 225 Fifth Suecl • Springfield.OR 97477 I hl(541)726 37 3 FAX(541)726-3689 sokEGON Date: // V/ 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 El Residential ❑Government ['Commercial Residential Qty. ea.t Total ca. cos' JOB SITE INFORMATION AND LOCATION First Appliance ( $80.00 $�} Job site address:,/97 6/- ./ Furnace/burner including ducts and vents City:),r,:V State:ar ZIP: 9P4,7 - Up to IOOk BTU/hr. 518.50 $ Over I00k I3111/hr. $22.00 $ Reference: Taxlot.: Heaters/stoves/vents DESCRIPTION OF WORK unit •healer $18.50 $ 4'94/ Wood/pellet/gas stove/tine $42.00 $ Repair/alter/add to heating appliance/ __ refrigeration unit or cooling system/ $80.00 $ PROPERTY OWNER absorption system Name: AS/Ar Evaporated cooler $14.50 Address: 7 -9- t,/ / Vent tan with one duct/appliance vent _S $10.00 $ �j Flood with exhaust and duel $14.50 $ Cilys�/� State:O� // �, ZIP:97y/jt Floor fiunace including vent $80.00 $ Phone:Y9 20f/2 I' Fax: - - Gas piping E-mail: f e//yam pu-e.---duy- rte 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 toy immediate family, and is exempt from licensing Air-handling units, including ducts requirements ttnd r ORS 701.0 0. Up to 10.000 CF�M $12.00 Signature: j ����c Over 10.000 CFtM $22.00 $ CONTRACTOR INSTALLATION Compressor/absorption system/heat pump Up to 3 hp/100k 131U $18.50 $ Business name: ��/1/[,__- Up to 15 hp/500k BTU $32.00 S Address: ---------.-. Up to 30 hp/1.000 13111 $47.50 $ City: State: ZIP: Up to 50 hp/1.750 BTU $62.50 $ Phone: - - Fax: - - Over 50 hp/1.750 BTU 5104.50 $ E-mail: Incinerators _ Domestic incinerator - $22.50 $ CCB license no.: --- Commercial Print name: Enter total valuation onnechanieal system and installation costs$ Signature: -...----- Enter fee based on valuation of mechanical system.etc, $ Miscellaneous fees Items Cost Total ea. cost Reinspection $80.00 $ • Specially requested inspections(per hr.) $80.00 $ Regulated equipment(unelassed) $14.50 $ Each additional inspection: (I) 580.00 $ APPLICANT USE (A) Enter subtotal of above lees(or enter set — mininuun fee of $80.00) $/OD . (B)Investigative lee(equal to IAI) $ (C)Enter 12%surcharge(.12 x IA+13]) $ ne'fre- (D)Seismic l'ee. I%(.01 x [A]) $ (Ii)Technology Fee(5%of[Al) $ 50i 440-2545-i(4/I/2013/COhq TOTAL fees and surcharges(A through E): $/i7 OD