HomeMy WebLinkAboutPermit Mechanical 2014-6-20 SPRINGFIELD 1 225 Fifth St
kirkCITY OF SPRINGFIELD Springfield,OR 97477
di," Phone: 541-726-3753
OREGON Building / Commercial Permit. Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2014-01340
www.springfield-ar.gov permitcenter @springfield-or.gov
PROJECT STATUS: Issued ISSUED: 06/20/2014 EXPIRES: 12/16/2014
STATUS DATE: 06/20/2014 APPLIED: 06/20/2014
SITE ADDRESS: 2750 GATEWAY ST,Springfield,OR 97477 SCOPE: Mechanical Only
ASSESOR'S PARCEL NO: 1703220002307 TYPE OF STRUCTURE: Commercial
PROJECT DESCRIPTION: Remove and replace 1 backup generator
OWNER: DAYTON HUDSON CORP Phone Number:
ADDRESS: TPN -0950
MINNEAPOLIS MN 55440
CONTRACTOR INFORMATION II
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
Mechanical Contractor AES MECHANICAL SERVICES GROUP INC CCB 182391 07/09/2016 334-252-0380
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
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Springfield Building Permit 6/20/2014 10:44:22AM IA tI 1 1g0 Dp Page 1 of 1
SPRINGFIELD- CITY OF SPRINGFIELD
�� • 225 Fifth St
TRANSACTION RECEIPT Springfield,OR 97477
OREGON 541-726-3753
811-SP R2014-01340
www.springfield-or.gov 2750 GATEWAY ST permitcenter @springfleld-or.gov
RECEIPT NO: 2014001351 RECORD NO:811-SPR2014-01340 DATE:06/20/2014
(DESCRIPTION ACCOUNT CODE/TRANS 6-66E7 „ AMOUNLDUE
Continuing Education Fee 224-00000-425606 2.50
Mechanical Permit fee(based on value of work) 224-00000-425604 1006 380.00
State of Oregon Surcharge(12%of applicable fees) - 821-00000-215004 1099 45.60
Technology fee(5%of permit total) 100-00000-425605 2099 19.00
TOTAL DUE: 447.10
L P,AYMEN_TTYPE PAYOR CASHIER:oBOWLSSr COMMENTS - .;_ 's AMOUNT PAID "• .')
Check AES MECHANICAL SERVICES GROL 447.10
035323 INC
TOTAL PAID: 447.10
Mechanical Permit Application DEPARTMENT USE ONLY
SPNINOPIELG S ��_ J 3 yb
G17'Y OF SPRLNGFCELD,'OR' EcoN 6,,:-„,,, ,t,?,;,s Permit no/:225 Fit h Street ♦ Springfield,OR 97477 ♦ PH(54l)726 3753 ♦ FAX(541)726-3689 6 ' Date: C Ze /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
❑ Residential ['Government 'ommercial Residential Qty. Cost Total
ea. cost
JOB SITE INFORMATION AND LOCATION First Appliance $82.00 $
Furnace/burner including ducts and vents
Job site address: '1 ssib ,'( e.. Up to 100k BTU/hr. $19.00 $
City.E P .; 5S Z iA State:QY ZIP:g-10-1^1 Over 100k BTU/hr. $22.00 $
Reference: I 76 32..Z6a ITaxlot.:OZTop Heaters/stoves/vents
DESCRIPTION OF WORK Unit heater $19.00 $
Wood/pellet/gas stove/flue $43.00 $
42-moo a ' - a t. Lt) w.. • Repair/alter/add to heating appliance/
refrigeration unit or cooling system/ $82.00 $
Cy.rm 0.. -JetrC absorption system
J PROPERTY OWNER Evaporated cooler $15.00 $
Name: Vent fan with one duct/appliance $10.00 $
or"rOj°'{ Hood with exhaust and duct $15.00 $
Address: c- c. \tt, - taut- ,-,--a k. atio Floor furnace including vent $82.00 $
CityMx,r,e.r-Toksy -State:m0 ZIP:55603 Gas piping
One to four outlets $8.00 $
Phone:(old Spa. 100'-13 I Fax: - - Additional outlets(each) $5.00 $
E-mail: `tee\ • pOedirs (a-\ on, c_cr ,-- 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 pump
Signature: Up to 3 hp/100k BTU $19.00 $
CONTRACTOR INSTALLATION Up to 15 hp/500k BTU $33.00 $
Up to 30 hp/1,000 BTU $49.00 $
Business name: A 4,5 CClee h.r,:,ea& carts . Up to 50 hp/1,750 BTU $64.00 $
Address:•Z 1--t % Over\1C1/2)%... 7.--7y1 Over 50 hp/1,750 BTU $107.00 $
City: \ 0.\\a tist.n. State: Est ZIP:'actotts, Incinerators
Domestic incinerator I I $22.50 I $
Phone:334 2S-z_- 0330 Fax:s q- 252 03x1 Commercial
E-mail: it -_ to a T. 1«h, co.„. Enter total valuation of mechanical system
CCB license no.: \t 4 and installation costs$ 31 201'1 . 00
Enter fee based on valuation of mechanical system,etc. $
Print name: Q_.-. j S� k u�� Miscellaneous fees Items Cost Total
sr,Signature: �� Specially re $82.00 $
Specially requested inspections (per $82.00 $
Regulated equipment(unclassed) $15.00 $
Each additional inspection:(I) $82.00 $
APPLICANT USE
•
(A)Enter subtotal of above fees(or enter set
' minimum fee of $82.00) $
(13)Investigative fee(equal to[A]) $
(C)Enter 12%surcharge(.12 x[A-FBI) $
(D)Seismic fee, 1%(.01 x[A]) $
' (E)Technology Fee(5%ofIA]) $
(F)Continuing Education Fee$2.50 $2.50
TOTAL fees and surcharges(A through F): $
440-2545-i(5/212014/COM) y��
•