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HomeMy WebLinkAboutPermit Mechanical 2014-07-28 (2)[01111 WK01 SUN 10 M =1 1:14 Building / Commercial Permit PERMIT NO: 811-SPR2014-01558 v .springfieldncgov 225 Fifth St Springfieid,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 permitcenter@spnngfield-ocgov PROJECT STATUS: Issued ISSUED: 07/28/2014 EXPIRES: 01/23/2015 STATUS DATE: 07/28/2014 APPLIED: 07/21/2014 SITE ADDRESS: 3333 RIVERBEND DR, Springfield, OR 97477 ASSESOR'S PARCEL NO: 1703220004102 -------PROJECT-DESCRIPTION:--- OWNER: ESCRIPTION: — OWNER: PEACEHEALTH ADDRESS: 1115 SE 164TH AVE SCOPE: Heating System TYPE OF STRUCTURE: Commercial Phone Number: VANCOUVER WA 98683 CONTRACTOR INFORMATION Contractor Type Contractor Name Lie Type Lie No Lie Exp Phone General Contractor GREENBERRY CONSTRUCTION LLC CCB 166612 - 09/26/2015 541-752-0381 Mechanical Contractor TWIN RIVERS PLUMBING INC CCB 17695 03111/2015 541-688-1444 INSPECTIONS REQUIRED Inspections 2300 Rough Mechanical Rough Mechanical: Prior to Cover 2999 Final Mechanical Final Mechanical: When all mechanical work is complete. 2420 Hydronic Piping 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 a property, and the approved set of plans will remain on the site at all limes during construction. 1j Owner or Contrac or Signature Date NOTICE: THIS PERMITS HALL EXPIRE IF THE WORK AUTHORIZED UNDER THIS PERMIT IS NO] COMMENCED OR IS ABANDONED FOR ANY 180 DAY PERIOD, 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 Oregon Utility Notification Center is 1.800.332-2344). Springfield Building Permit 7/28/2014 3:13:01PM Page 1 of 1 SPRINGFIELD -- CITY OF SPRINGFIELD TRANSACTION RECEIPT 225 Fifth St Spdngfie1d.0R 97477 oaeaoN 811-SPR2014-01558 541-7263753 v m.spdngfieldacgov 3333 RIVERBEND DR permitcenter@spdngfield-or.gov RECEIPT NO: 2014001620 RECORD NO: 811-SPR2014.01558 DATE: 07/28/2014 Continuing Education Fee 224-00000-425606 2.50 Mechanical Permit fee (based on value of work) 224-00000-425604 1006 250.35 Special Occupancy Fee 224-00000-425602 1097 2.50 State of Oregon Surcharge (12% of applicable fees) 821-00000-215004 1099 30.04 Technology fee (5% of permit total) 100-00000-425605 2099 12.52 TOTAL DUE: 297.91 Check GREENBERRY CONSTRUCTION LLC 297.91 22711 TOTAL PAID: 297.91 CATEGORY OF CONSTRUCTION E) Residential I ❑ Government ® Commercial JOB SITE INFORMATION AND LOCATION Job site address: 3333 Riverbend Way City: Springfield I State: OR ZIP: 97477 Reference: Selmens 1.6 T MRI Taxlot: _ DESCRIPTION OF WORK Hydronlc piping PROPERTY OWNER Name: Sacred Heart Medical Center at Riverbend Address: 3333 Riverbend Dr City: Springfleld State: OR ZIP: 97477 Phone: 641 -337 -8532- 1 $ E -mail: This installation is being made on property owned by me or a member of my immediate family, and is exempt fiont licensing requirements under ORS 701.010. Signature: CONTRACTOR INSTALLATION Business name: Twin Rivers Plumbing Address: 1626 Irving Rd. City: Eugene State: OR ZIP: 97404 Phone: 641-6E Fax: 641-688-9272 E-mail: Gerry@twinrp.com CCB license no.: 17695 Print name: Gerald S. Bush Signature: 440-2545-J (5/2112014/CO3M) FEE SCHEDULE Residential Qty, cost ca. 'total cost First Appliance 1 1 $82.00 Furnace/burner including ducts and vents Up to 100k BTU/hr. $19.00 $ Over I 00 BTU/hr. $22.00 1 $ Heaters/stoves/vents Unit heater $19.00 $ Wood/pellet/gas stove/flue $43.00 $ Repair/alter/add to heating appliance/ refrigeration unit or cooling system/ absorption sstem $82.00 $ Evaporated cooler $15.00 $ Vent fan with one duct/appliance $10.00 $ flood with exhaust and duct $16.00 $ Floor furnace including vent $82.00 $ Gas piping One to four outlets I 1 $8.001 $ Additional outlets (each) $5.001 $ Air -handling units including duets Up to 10,000 CFM $12.00 $ Over 10,000 CFM I $22.00 $ Corn ressor/absor tions stent/heat unn Up to 3 hp/100k BTU I $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 $ Incinerators Domestic incinerator $22.60 $ Commercial Enter total valuation of mechanical system and installation costs $ 17,428.00 Enter fee based on valuation of mechanical system, etc. $ ZSO Miscellaneous fees ftenisl cost ea. Total cost Reinspection $82.00 $ Specially requested inspections (pe $82.00 $ Regulated equipment (unclassed) $15.00 $ Each additional inspection: (1) APPLICANT `USE (A) Enter subtotal of above fees (or enter set minimum fee of $ 82.00) $ U (B) Investigative fee (equal to [A]) $ (C) Enter 12% surcharge (.12 x [A+B]) $ 122, (D) Seismic fee, 1%(.O1 x [A]) $ ✓ (E) Technology Fee (5% of [A]) $ 5 (F) Continuing Education Fee $2,50 $2.50 TOTAL fees and surcharges (A through F): $ 1