HomeMy WebLinkAboutPermit Mechanical 2014-5-20 Jl 1••
SPRINGFIELD 225 Fifth St
r
CITY OF SPRINGFIELD Springfield,OR 97477
Phone: 541-726-3753
REGON Building I Commercial Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2014-01086
www.springfield-or.gov permitcenter @springfield-or.gov
PROJECT STATUS: Issued ISSUED: 05/20/2014 EXPIRES: 11/15/2014
STATUS DATE: 05/20/2014 APPLIED: 05/16/2014
SITE ADDRESS: 1660 MOHAWK BLVD,Springfield,OR 97477 SCOPE: Mechanical Only
ASSESOR'S PARCEL NO: 1703253105600 TYPE OF STRUCTURE: Commercial
PROJECT DESCRIPTION: Replace Pkg gas HVAC units(2 total)
OWNER: 1ST CONSERV BAPT CHRCH SPFD Phone Number:
ADDRESS: 1660 MOHAWK ST
SPRINGFIELD OR 97477
L CONTRACTOR INFORMATION
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
Mechanical Contractor HARVEY&PRICE CO CCB 77 10/31/2014 541-746-1621
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.
j/Li, A a4e1 6 — d r for C`/
Owner or Contractor Signature . Date
ATTENTION: Oregon Iaw requires you to
follow rules adopted by the Oregon Utility
Notification Center. Those rules are set forth
In OAR 952-001-0010 through OAR 952-001- `�I GE:
0090. You may obtain copies of the rules by •
c j HIS PERMIT SHALL EXPIRE IF THE WORK
calling the center. (Note: the telephone
number for the Oregon •Utility Notification AUTHORIZED UNDER THIS PERMIT IS NOT
Center is 1-soo-332-2344), COMMENCED OR IS ABANDONED FOR
Springfield Building Permit 5/26/2614 11:27:55AM ANY 180 DAY PERIOD. Page 1 of 1
SPRINGFIELD—, CITY OF SPRINGFIELD
((``� 225 Fifth St
"� '``O EGON TRANSACTION RECEIPT Springfield,OR 97477
541-726-3753
811-SPR2014-01086
www.springfield-or gov 1660 MOHAWK BLVD permitcenter @springfield-or.gov
RECEIPT NO: 2014001100 RECORD NO: 811-SPR2014-01086 DATE:05/20/2014
[DESCRIPTION— CODE,__ __ ,AMOUNT.DUE •
Mechanical Permit fee(based on value of work) 224-00000-425604 1006 214.24
State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 25.71
Technology fee(5%of permit total) 100-00000-425605 2099 10.71
TOTAL DUE: 250.66
LPAYMENT_TYPE, _PAYOR_ CASHIER:CCARPENTER COMMENTS _:,.,m_-� -AMOUNT PAID - f
Check HARVEY& PRICE CO 250.66
035155
TOTAL PAID: - 250.66
Mechanical Permit Application DEPARTMENT USE ONLY
ti - t 1 , wt... fry , ' r �,,,, SPRINGFIELD __ Q
, ITY OILli GFIEtigepi G�ON> Permit no.: Siy'
_225 Ffih Street ♦ S nn field,OR 97477 • PH(54l)726-3713 • FAa(54 U726-7689 5 ./�OR EGON Dale:
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 •
ea. cost
JOB SITE INFORMATION AND OCATI�ON First Appliance $80.00 $
1 /' / c, f((/7sc rf�l,.�Q [6{1 t4 Furnace/burner including ducts and vents
Job site address: 10 Lc, 0 r t l7Gl W Y- t .n�cr- !
City: State: 6- ZIPGq-7c _'-� Up to IOOk BTU/hr. $18.50 $
v- Over IOOk BTU/hr. $22.00 $ 1
`7
Reference: 03 z; 3 I -1'axlot.:�
00 Heaters/stoves/vents
DESCRIPTION OF WORK Unit heater $18.50 $ {
tk • G.I • - • f- (4 Ot • Wood/pellet/gas stove/floc $42.00 $ I
� Repair/alter/add to heating appliance/ I
.R�im
.1l A refrigeration unit or cooling system/ $80.00 $
PROPERTY OWNER absorption system
-41 vaporated cooler $14.50 $
Name:�(,0(,(/1 lL-IV•�UrIJ �LJ'��-znv{!�
Address:tLtc � t j� (� ent fan with one duct/appliance nee vent $10.00 $
Hood.with exhaust and duct $14.50 $
City: State(81.1 ZIPgc q Floor furnace including vent $80.00 $
Phone: •/-��`L--�' Fax: - - Gas piping
E-mail: One to four outlets 1 $7.501 $
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 1
requirements under ORS 701.010. Up to t0,000 CENT ( $12.00 $
I
Signature: Over 10.000 CFM $22.00 $
CONTRACTOR INSTALLATION Compressor/absorption system/heat pump
Business name: �,�) Q(_ Up to 3 hp/100k BTU $18.50 $ 1
e� 9.! Up to 15 hp/500k BTU $32.00 $ i
Address: Zo( '5 N Cr.Cmc ..Q_4- C.t Up to 30 hp/I.000 BTU $47.50 $
City: 2V1--C I State: en I ZIPC? -7Ca 0 Up to 50 hp/1.750 BTU $62.50 $
Phone.6C-1-( -7C4. - ( e-71 fPax: - - Over 50 hp/1.750 BTU $104.50 $
`
,_],fl tors
E-mail:aea • a at 6_. _• - Oa' ..' - ‘D�41r1eiiFtic``Incinerator I $22.50 $ !
CCB license no.: 7/ ) • Commercial I
Print name: �_O r• L�421.r. Enter total valuation of mechanical system /J �/,r� j M
_l.` and installation costs$ I i !ice
Signature:
V`, Enter fee based on valuation of mechanical system.etc. $
Miscellaneous fees Items C Total
ea ost cost
Reinspection $80.00 $
Specially requested inspections(per hr.) $80.00 $
Regulated equipment(unclassed) $14.50 $
Each additional inspection:(t) $80.00 $
APPLICANT USE
(A)Enter subtotal of above fees(or enter set
minimum fee of $80.00) $ 2/C(,_.
(B)Investigative fee(equal to[A]) $
(C)Enter 12%surcharge(.12 x[A+B]) $ as-2-1-
(D)Seismic fee, I%(.01 x[A]) $
(E)Technology Fee(5%of[A]) $ /0 If
440-2545-3(4/1/2013/COM) TOTAL fees and surcharges(A through E): 0 G
$2