HomeMy WebLinkAboutPermit Electrical 2014-5-12 SPRINGFIELD _. 225 Fifth St
CITY OF SPRINGFIELD Springfield,OR 97477
Phone: 541-726-3753
\ OREGON
Building / Commercial Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2014-01044
www.springfield-or.gov permitcenter @springfield-or.gov
PROJECT STATUS: Issued ISSUED: 05/12/2014 EXPIRES: 11/07/2014
STATUS DATE: 05/12/2014 APPLIED: 05/12/2014
SITE ADDRESS: 1623 21ST ST, Springfield,OR 97477 SCOPE: Electrical Only
•ASSESOR'S PARCEL NO: 1703250000801 TYPE OF STRUCTURE: Commercial
PROJECT DESCRIPTION: Flood Plain-Install HP must be installed 1'above base flood elev.
OWNER: MARSHALL FISHER LLC Phone Number:
ADDRESS: 1623 21ST ST STE A
SPRINGFIELD OR 97477
CONTRACTOR INFORMATION
Contractor Type Contractor Name - Lic Type Lic No Lic Exp Phone
Mechanical Contractor PRIORITY ONE HEATING&AIR CONDITIONING INC CCB 154686 03/30/2015 541-689-1004
INSPECTIONS REQUIRED
aa1 V
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
ATTENTION: Oregon law requires you to j�- 4 •follow rules adopted by the O�eg jn ditty NOTICE: '
Notification Center. Those rule 'ire set for*
in OAR 952-001-0010 through OAR 952-001I-,1 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 5/12/2014 2:59:11PM Page 1 of 1
SPRINGFIELD CITY OF SPRINGFIELD
•
hir:;"...... 225 Fiflh SI
; `O EGON TRANSACTION RECEIPT Spdngfield.OR 97477
\ 541-726-3753
811-5 PR2014-01044
www.springfield-or.gov 1623 21ST ST permitcenter @springfield-or.gov
RECEIPT NO: 2014001035 RECORD NO: 811-SPR2014-01044 DATE: 05/12/2014
[DESCRIP_T,ION . - a. ACCOUNT_CODE/TRANS CODE < '._AMOUNT DUE_
Mechanical Permit fee(based on value of work) 224-00000-425604 1006 110.98
State of Oregon Surcharge (12%of applicable fees) 821-00000-215004 1099 13.32
Technology fee (5%of permit total) 100-00000-425605 2099 5.55
TOTAL DUE: 129.85
_ AMOUNT PAID -
�;;�� PAYOR , casNIER'�I_nRSON -' , `COMMENTS , _ _�.:. .. ; > _,.^
Credit Card PRIORITY ONE HEATING -&—AIR 129.85
02976G CONDITIONING INC
TOTAL PAID: 129.85
•
May 12 14 10:28a Priority One Heating 5416074457
•
'Mechanical Permit Application DEPARTMENT USE ONLY
�/--++ v _ ,._ SPRINGFIELD
err}'OF 'RING ELD, OREcoN Permit no.9EzevA -Otb4"\
.-,
225 Fifth Street• Spnn to d,OR 97477 • PH(5I1)72G 3753 • FAX(541)72E 3639 �odEGON Date: 15.-// Zl i L(
This permit is issued under OAR 918-440-0050. Permits expire if work is not started within IRO days of issuance or if worlt is
suspended for 180 days.
CATEGORY OF CONSTRUCTION FEE SCHEDULE
0 Residential I El Government Commercial Residential Qty, Cost Total
ea. . cost
JOB SITE INFORMATION AND LOCATION First Appliance $80.00 S
lob site address: ( (cja3 (V 11 2 (�.I.- 51-- Furnace/burner including ducts and vents
Citys(�J)1\ el e,� State: 09_, zip: ennui Up to 100k BTU/hr. $10.50 $
1f Over 100k BTU/hr. $22.00 $
Reference: Taxlot.: Heaters/stoves/vents
DESCRIPTION OF WORK t Unit heater $18.50 $
tarp-CAA ,j-- bu---rb t
ooa -k-P Wood/pellet/gas stove/flue $42.00 S
Repair alter/add to heating appliances
refrigeration unit or cooling system/ $80.00 $
/// PROPERTY OWNER absorption system
Name: 1`. l�yt d,r�r /5 hey' Evaporated cooler $14.50 $
S Vent fan with one ducVappliance vent $10.00 $
Address: '‘,6Z3 ii J- ire rf- -
Hood with exhaust.and duet $14.50 $
City: f6t/A State: u� l ZIP: S7y 7 7 Floor furnace including vent $80.00 $
Phone: /�- - Fax: - - Gas piping ,
E-mail: One to four outlets I 57.50_ S
This installation is being made on property owned by me or a Additional outlets(each) 54.50 S
member of ray immediate family, and is exempt from licensing Air-handling units, including ducts
requirements under ORS 701.010. Up to 10.000 CEM I $12.00 5
Signature: Over 10.000 CFM $22.00 5
CONTRACTOR INSTALLATION Compressor/absorption system/heat pump
pr[Orc� Ong_ t I � /, ? 1 Up to3ltpsl00kBTU $10.50 $
Business name: 4'�LLf q
Address: Con-t✓narce ev I I I # Up to 15 hp/800 BTU $32.00 $
Up to 30 hp/1..000 BTU $47.50 $
City: C2,1.A cjt. -L2 State: 02 z [' 7L4-Q -. Lip in 50 hp/1,750 BTU $62.50 $
PhoneoL(( -(QSa- [004 F-ac54( -(Ob1_�t4�C�`{� 7 Over 50 hp/[,750 BTU S104.50 $
E-tnail:�' .2,; 1.fobb1 ris€�Prlort ill ovt,et l✓nq Incinerators
t ' -lDrn Domestic incinerator 1 • I $22.50 $
CCB license no.: Commercial
Print name:
•Irk rh. • A)1A Enter total valuation of mechanical system• I-r_- and installation costs$ coot/_
�\
Signature: I J'J
Enter fee based on valuation of mechanical system.etc. $
Miscellaneous fees Items Cost Total
ca. cast
< +w:+e.4re. Reinspeclion $80.00 I $
Specially requested inspections(per hr.) $00.00 $
OOSC; Regulated equipment(unclassed) $14.50 I $
t^ P at OAP �o„�y-� t' Each additional inspection: (I) j $80.00 $
H w a�� 45C APPLICANT USE
44004 ce [I$t.4-,0.. (A)Enter subtotal of above fees(or enter set
minimum fee of $80_00) $
(B) Investigative fee(equal to [AJ1 $
(C)Enter 12%surcharge(.12 x[.4+B]) $
(D)Seismic tee. I%(.01 x [A]) $
(E)Technology Fee(5%of[A]) $
440-2515-1( 112013/COM) TOTAL fees and surcharges(A through E): SiZr-1-5-