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Home My WebLink AboutPermit Mechanical 2014-07-16SPRINGFIELD 225 Fifth St OwneContractor Signature t, CITY OF SPRINGFIELD Springfield,OR97477 { v Phone: 541-726-3753 ' OREGON Building / Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2014-01528 vnvw.spnngfield-or.gov permitcenter@spnngfield-or.gov PROJECT STATUS: Issued ISSUED: 07/16/2014 EXPIRES: 01/11/2015 STATUS DATE: 07/16/2014 APPLIED: 07/16/2014 SITE ADDRESS: 1351 LAWNRIDGE AVE, Springfield, OR 97477 SCOPE: Mechanical Only ASSESOR'S PARCEL NO: 1703252206000 TYPE OF STRUCTURE: Residential –PROJECT DESCRIPTION;—M- Air conditioner OWNER: BRUHN-SMITH ANGELA D Phone Number: ADDRESS: 1351 LAWNRIDGE AVE 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 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, it r P1RE IE THE �I ORK �� S'PERMIY SNAI.i. IVIS PERM1t IS NOT pt1TNORIZED u0R IS ARAN®ONED EOR 10 M80 DAY PER1013. ATTENTION: Oregon law 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- 0090. You may obtain copies of the rules by calling the center. (Note: the telephone number for the Orgon Center is 1e800.332Utility344) ficatiott Springfield Building Permit 7/16/2014 10'.30:11AM Page 1 of 1 OwneContractor Signature Dale P1RE IE THE �I ORK �� S'PERMIY SNAI.i. IVIS PERM1t IS NOT pt1TNORIZED u0R IS ARAN®ONED EOR 10 M80 DAY PER1013. ATTENTION: Oregon law 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- 0090. You may obtain copies of the rules by calling the center. (Note: the telephone number for the Orgon Center is 1e800.332Utility344) ficatiott Springfield Building Permit 7/16/2014 10'.30:11AM Page 1 of 1 S PRINGFIELD Cl I'1' OF SPRINGFIELD -225 Fifth Sl �,TRANSACTION RECEIPT Springfield,OR97477 REGON 811-SPR2014-01528 541-726-3753 wmv.springfield-ocgov 1351 LAWNRIDGE AVE permits nter@spdngrield-ocgov RECEIPT NO: 2014001527 RECORD NO: 811-SPR2014.01528 DATE: 07/16/2014 DESCRIPTION ACCOUNT CODE/TRANS CODE AMOUNT DUE 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 Check KENT WITHAM AIR INC 2638 98.44 TOTAL PAID: 98.44 Mechanical Permit Application DEPARTMENT USE ONLY SPRINGFIELD cc�� ® r 1 ® ®.5 ,, y Permit no.: - 225 Fifth Street ♦ Springfield, OR 97477 ♦ PH(541)726-3753 FAX(541)726-3689 Date: / 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 Residential ❑ Government ❑ Commercial JOB SITE INFORMATION AND LOCATION Job site address: La t,.s h ttel e CiV,5PcinPip id State:p R ZIP: Wg7.r -Reference: Taxlot DESCRIPTIONt( OF WORK L- PR_OPERTY OWNER ' Name: N el A'Bcokyl Address: 3 S / LgWnrr`d City: 699 -Pe 1.6 State:o9 ZIP: 97q77 Phone: Fax: E-mail: This installation is being made on property owned by me or a member of my immediate family, and is exempt from licensing requirements under ORS 701.010. Signature: CONTRACTOR INSTALLATION Business name: 211 o-51YYt 'r' Address: Vo Box m -a City: S6fln )If [d I State: ep& ZIP: c/71 Phone: 94-y'vm 45-96 Fax5771 (fie ¢Q Z(0 E-mail: KUDCAl ,r -O b 1 CCB license no.: j B c2 $3 Print name: K-0 1 Q Signature: 440-2545-3 (5/21/2014/COM) 'FEE SCHEDULE ResidentialQty, Cost -ea. Total cost First Appliance $82.00 Furnace/burner including ducts and vents Up to 100k BTU/hr. $19.001 $ Over 100k BTU/hr. $22.00 $ _Rea r to es _vents Unit heater $19.00 $ Wood/pellet/gas stove/flue $43.00 $ Repair/alter/add to heating appliance/ refrigeration unit or cooling system/ absor tion system $82.00 $ Evaporated cooter $16.00 $ Vent fan with one duct/appliance $10.00 $ Hood with exhaust and duct $16.00 $ Floor furnace including vent $82.00 $ Gas piping One to four outlets $8.00 $ Additional outlets (each) 1 $6.00 $ Air -handling units including ducts Up to 10,000 CPM I 1 $12.00 $ Over 10,000 CFM 1 1 $22.00 $ Compressor/absorption sstem/heat DURID Up to 3 hp/100k BTU 1 $19.00 $ Up to 15 hp/500k BTU $33.00 $ Up to 30 hp/1,000 BTU $49.00 $ Up to 50 hp/1,750 BTU $64.00 $ Over 50 hp/1,750 BTU $107.00 1 $ Incinerators Domestic incinerator 1 1 $22.60 $ Commere[al Enter total valuation of mechanical system and installation costs $ _ Enter fee based on valuation of mechanical system, etc. $ Miscellaneous fees tem cost - ca. Total cost '- Reinspection $82.00 $ Specially requested inspections (pe $82.00 $ Regulated equipment (unclassed) $16.00 $ Each additional inspection: (1) $82.00 $ iAPPLICANT ;USE (A) Enter subtotal of above fees (or enter set minimum fee of $ 82.00) $ Lb �_ (B) Investigative fee (equal to [A]) $ (C) Enter 12% surcharge (.12 x [A+B]) $ (D) Seismic fee, 1%(01 x [A]) $ (E) Technology Fee (6% of [A)) $ -i (F) Continuing Education Fee $2.50 $2.50 TOTAL fees and surcharges (A through F): $