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HomeMy WebLinkAboutPermit Mechanical 2014-6-17 SPRINGFIELD - 225 Fifth St • '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-SPR2014-01305, ervry,springfield-or.goy - permitcenter @springfeld-ar.gov PROJECT STATUS: Issued ISSUED: 06/17/2014 EXPIRES: 12/13/2014 STATUS DATE: 06/17/2014 APPLIED: 06/17/2014 SITE ADDRESS: 570 JANUS ST,Springfield,OR 97477 SCOPE: Mechanical Only ASSESOR'S PARCEL NO: 1703341200900 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: DHP OWNER: HASTIE D'WAYNE C&CARLA L Phone Number: ADDRESS: 570 JANUS ST SPRINGFIELD OR 97477 • CONTRACTOR INFORMATION - Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone Mechanical Contractor KENT WITHAM AIR INC CCB 189283 01/20/2016 541-543-6580 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. 7,7 wner or Contractor Signature Date ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility NOTICE: Notification Center. Those rules are set forth THIS PERMIT SHALL EXPIRE IF THE WORK irl OAR 952-001-0010 through OAR 952-001- AUTHORIZED UNDER THIS PERMIT IS NOT 0090. You may obtain copies of the rules by COMMENCED OR IS ABANDONED FOR calling.the center. (Note: the telephone number for the Oregon Utility Notification ANY 180 DAY PERIOD. • Center is 1-800-332-2344). • Springfield Building Permit 6/17/2014 9:39:11AM Page 1 of 1 • • 1 — SPRINGFIELD CITY OF SPRINGFIELD TRANSACTION RECEIPT Spn Fifth St Tyk.'O 541-726-3753 oRS�oN 811-SPR2014-01305 www.springfield-or.gov 570 JANUS ST . permitcenter©spnngfield-or.gov RECEIPT NO: 2014001318 RECORD NO:811-SPR2014-01305 DATE:06/17/2014 [o , L :.a , ,4,`i-#t r%, ,y t ili , 8,,Eb ACCOUNT,CODE/TRANS`CODE-k "'r.:4 S AMOUNT • Continuing Education Fee 224-00000-425606 2.50 First Appliance Fee 224-00000-425604 1006 82.00 State of Oregon Surcharge(12%of applicable fees) • 821-00000-215004 1099 9.84 Technology fee(5%of permit total) 100-00000-425605 2099 4.10 TOTAL DUE: 98.44 :PAVMENSaTYP.E,___.:z PAVOR CASHIePTISR50N _ .,��\::"COMMENTS _ ��-:` . � ;t� _ '`_AMO.PMTPAID Check Kent Witham Air. 98.44 2610 TOTAL PAID: 98.44 • • • • • • Mechanical Permit Application DEPARTMENT OE ONLY _° .^, €ne:,.1m�^ Ow F S, p^ye.RN„3 G..2.F,. I.z Etf T D..-_;..rOre r„ R rc Ea GO N e -ZxI"` PRN- GFIELD • '.., . , Permit no 47/( 20/1-11 -X1305 , 225 Fifth Street• Springfield,OR 97477 • PH(541)726-3753 • FAX(541)726-3689 4fi . / /� Date: �/ �7 ei' 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. ,,:;; i4: ; CATEGORY?OF;CONSTRUCTION %'i ,;.e.., 2 ,,, ', ?FEE`'`SCHEDULE 4s z :. Cost Total ® Residential ❑Government iii Commercial Residential r,r�' _ si'-vlQty w. �R �„_ .- .,,:ea. .cost "t;??.`6 JOB4SITE INFORMATION,AND LOCATION,�1� , First Appliance I / ,. $82.00 $ Furnace/burner including ducts and vents Job site address: ,j 73 30.hr Ce Up to IOOk BTU/hr. $19.00 $ City: S y-f I YY3 1 2-1 P[o. State: Pk ZIP: q7 477 Over 100k BTU/hr. $22.00 $ Reference: Taxlot.: Heaters/stoves/vents ; : " Unit heater 4: ?i DESRIPTON;'OF WORK a ,1a t W $19.00 $ ood/pellet/gasstove/flue $43.00 $ __1 Sk'o,I C e N��P 11^ Repair/alter/add to heating appliance/ refrigeration unit or cooling system/ $82.00 $ absorption system ' 05 °`, $ PR'OP,ERTYL'OWNER ?, ?u Evaporated cooler $15.00 $ Name: d`7b.'xkit12 Kos 1_1 e Vent fan with one duct/appliance $10.00 $ Hood with exhaust and duct $15.00 $ Address: 5-70 „jh N 1 t e Floor furnace including vent $82.00 $ City: SPf l ny el e td State:©R ZIP: 17 L/77 Gas piping Phone: - - Fax: - - One to four outlets $8.00 $ Additional outlets(each) , $5.00 $ E-mail: Air-handling units,including ducts This installation is being made on property owned by me or a Up to 10,000 CFM $12.00 $ member of my immediate family, and is exempt from licensing Over 10,000 CFM , $22.00 $ requirements under ORS 701.010. Compressor/absorption system/heat •ump Signature: Up to 3 hp/100k BTU $19.00 $ ' 2;C_ONTRACTOR INSTALLATION " } <.,',,,;;c Up to 15 hp/500k BTU $33.00 $ JeNt 1n'-- - a- - Up to 30 hp/1,000 BTU $49.00 $ Business name: I\ W t i vt0.Y>1 A-iC 11C- , Up to 50 hp/1,750 BTU $64.00 $ Address: 'pf1 73o)C 17.58' . Over 50 hp/1,750 BTU $107.00 $ City: S 1-t yl9 c e b State:O ZIP: 9 7 y77 Incinerators _ _ ,�,r�-aa ,,TT// ,./ Domestic incinerator $22.50 $ Phone:911-,h43- ✓5' O Fax5 ( -�r�- y92� Co mrnercla ,,.. _ �. .r , t< 54;T is : ;s 3 E-mail: / LJO Co CG ge f{o ; I .00)-4 Enter total valuation of mechanical system CCB a8 and installation costs$ CB license no.: Enter fee based on valuation of mechanical system,etc. $ Print name: Keys I_ Q _ M iscellahn'eor us fees ( #T�. Ite• s Cr Toalt' i - - �. ,y.ea. [ ''''.::cost:',=, Signature: A ''/ ice' Reinspection $82.00 $ Specially requested inspections (per $82.00 $ Regulated equipment(unclassed) $15.00 $ Each additional inspection:(I) $82.00 $ , t`r.r".;k%MPPLICANT4`USELrn,' ' .t .`. !'r'„ (A)Enter subtotal of above fees(or enter set minimum fee of $82.00) $ (B)Investigative fee(equal to[A]) $ (C)Enter 12%surcharge(.12 x[A+B]) $ (D)Seismic fee, 1%(.01 x [A]) - $ (E)Technology Fee(5%of[A]) $ (F)Continuing Education Fee$2.50 $2.50 TOTAL fees and surcharges(A through F): $ 76--- 440-2545-1(5212014/C0M)