HomeMy WebLinkAboutPermit Mechanical 2014-09-23VSPRINGFIELD
( t�r3
-OREGON
www. spnngfield-or.gov
CITY OF SPRINGFIELD
Building / Residential Permit
PERMIT NO: 811-SPR2014-02065
PROJECT STATUS: Issued
STATUS DATE: 09/2312014
SITE ADDRESS: 5915 G ST, Springfield, OR 97478
ASSESOR'S PARCEL NO: 1702342200420
PROJECT DESCRIPTION: Wood stove insert
OWNER: SHOSHIN AMBER M & ETHAN
ADDRESS: 5915 G ST
225 Fifth St
Springfield,OR 97477
Phone: 541-726-3753
Inspection Phone: 541-726-3769
Fax: 541-726-3676
permitcenter@springfield-er.gov
ISSUED: 09/23/2014 EXPIRES: 03/2212015
APPLIED: 09/23/2014
SCOPE: Wood Stove / Insert
TYPE OF STRUCTURE: Residential
Phone Number:
SPRINGFIELD OR 97478
CONTRACTOR INFORMATION
Contractor Type Contractor Name Lic Type Lic No Lie Exp Phone
Mechanical Contractor EMERALD SWIMMING POOLS OF OREGON INC CCB 11204 10/23/2015 541-886-1090
INSPECTIONS REQUIRED
Inspections
2140 Pellet, Gas, Fireplace or Wood Wood Stove: After Installation.
Stove
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 Stale 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 Safely. 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
I,liMCE:
IS PERMIT SHALL EXPIRE IF THE WORK
All I1IORIZED UNDER THIS PERMIT IS NOT
col.INIENCED OR IS ABANDONED FOR
,'011111 180 DAY PERIOD.
/21y
Date
�l Tt=N-i ION: Oregon law requires you tO
„v macs adopted by the Oregon Utility
ion Ccntor. Those rules are setforth
C, ,,, n'),?. -001 -0010 through OAR 952 -001 -
yr)! 1
52.001-
Ynr1 may obtain Copies of the rules by
the Genier. (Note: the telephone
for the Oregon Utility Notification
Center is 1-800-332-2344).
Springfield Building Permit 9/23/2014 2:09:55PM Page 1 of 1
YPRINGEIELD -
CITY OF SPRINGFIELD
TRANSACTION RECEIPT
225 Fflth St
Spdngheld,OR97477
ONEGON
811-SPR2014-02065
541-726-3753
w .springheld-or.gov
5915 G ST
permitcentef@spdngrield-or.gov
RECEIPT NO: 2014002114 RECORD NO: 811-SPR2014.02065 DATE: 09/23/2014
DESCRIPTION ACCOUNT CODE/TRANS CODE AMOUNT DUE
Continuing Education Fee 224-00000-425606 2.50
First Appliance Fee 224-00000-425604 1006
State of Oregon Surcharge (12% of applicable fees) 821-00000-215004 1099
82.00
9.84
Technology fee (5% of permit total) 100-00000-425605 2099 4.10
TOTAL DUE: 98.44
PAYMENT TYPE PAYOR CASHIER: CCARPENTER i COMMENTS AMOUNT PAID
Check SHOSHIN AMBER M & ETHAN 98.44
6462
TOTAL PAID: 98.44
Mechanical Permit A
225 Fifih beet a Springfield, OR 97477 e
5-12 1-3
This permit is issued under OAR 918-440-0050.
suspended for 180 days.
CATEGORY OF CONSTRUCTION
Residential 10 Govermnent
❑Commercial
JOB SITE INFORMATION AND LOCATION
Job site address:
City. 1�V
Total
cost
FirstApplianc
State:
ZIP.
Refen e: Taxlot.:
DESCRIPTIO OF WORK
-n d
PROPERTY OWNER
Name: E %os I
Address; r
City: V"InawMA
State: UP,ZIP:oh4-1
Phone: -� Fax; L.f , I U-
E -mail: ,QXGhos h IYI(? Qo.
This installation is being made on pro owned by me or a
member of my iunnediate f oily d is exenIqroin licensing
requiremn unde ORS 70 10,
Signatur
CONTRA R STALLATION
Business name:
Pod 1 .I]
Address: Q
City:one,State:
$
(( ZIRILf 02
phone:—CW-
, 66e), I a O Fax:
E-mail:
CCB license no.:
Print name:
Signature:
440.25454(4/1/2013/COW
DEPARTMENT USE ONLY
— Sr
permit no.: 2,L*
Date:
is not started within 180 days of issuance or If work is
FEE SCHEDULE
Residential
Qty,
Cost
en.
Total
cost
FirstApplianc
$SOA
Fornacelburner including ducts mrd vents
Up to 100k BTUAn.
$18.60
$
Over IOOk BTU/hr.
$22.00
$
Heaters/stoves/vents
Unit heater
$18.50
$
Wood/pellet/gas stove/flue
$42.00
$ Q—
Repair/alter/add to heating appliance/
refrigeration unit or cooling system/
absorption system
$80.00
$
Evaporated cooler
$14.60
S
Vent fan whir one duct/appliance vent
$10.00
S
Hood with exhaust and duct
$14.60
$
Floor fiunace including vent
$80.00
$
Gas piping
One to four outlets
$7.60
$
Additional outlets(cach) 1
1
$4.601
S
Air -handling units, including ducts
Up to 10,000 CF&I
$12.00
$
Over 10,000 CFM
$22.00 1
$
Com ressm•/absor tionsystem/he t nun r
Up to 3 hp/IOOk BTU
$18.50 1
$
Up to 15 hp/500k BTU
$32.00
$
Up to 30 hp/1,000 BTU
$47.60
$
Up to 501np/1,750 BTU
$62,60
$
Over 501np/1,750 BTU
$104.60
$
Incinerators
Domestic incinerator
$22.60 1
$
Commercial
Enter total valuation of mechanical system
and installation costs $ _
Enter fee based on valuation of mechanical system, etc.
$
Miscellaneous fees Iterus
Cost
ea,
Town,
cost
Reinspectioir
$80.00
$
Specially requested inspections (per hr.)
$80.00
$
Regulated equipment(unclassed)
$14.50
$
Each additional inspection: (1)
$80.00
S
APPLICANT USE
C
Z
(A) Enter subtotal of above fees (or enter set
minimmn fee of $ 80_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 (6% of [A])
$
I
TOTAL fees and surcharges (A through E): $
qf
VON