HomeMy WebLinkAboutPermit Mechanical 2014-10-02SPRINGFIELD
EXPIRES: 03/31/2015
225 Fifth Sl
Q
CITY OF SPRINGFIELD
Springfield,OR97477
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6
Commercial
Phone: 541-726-3753
OREGON
Building / Commercial Permit
Inspection Phone: 541-726-3769
ADDRESS: PO BOX 482
Fax: 641-726-3676
PERMIT NO: 811-SPR2014-02140
w .spdngfield-0r.gov
Lie No Lie Exp Phone
permitcenter@spdngfield-ocgov
PROJECT STATUS: Issued ISSUED: 10/02/2014
EXPIRES: 03/31/2015
STATUS DATE: 10/02/2014 APPLIED: 10/02/2014
SITE ADDRESS: 445 HARLOW RD, Springfield, OR 97477
SCOPE: Mechanical Only
ASSESOR'S PARCEL NO: 1703224407200 TYPE OF STRUCTURE:
Commercial
PROJECT DESCRIPTION: Replacing a package unit (AC).
OWNER: RADIOLOGY ASSOCIATES PC
Phone Number:
ADDRESS: PO BOX 482
EUGENE OR 97440
CONTRACTOR INFORMATION
Contractor Type Contractor Name Lie Type
Lie No Lie Exp Phone
Mechanical Contractor SUNSET HEATING & AIR INC CCB
171706 08/18/2016 541-554-2604
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 Ioca1Qd'1Pthe front of the property, and the approved set of plans will remain on the site at all times during
construction. . /
Signature Date
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Springfield Building Permit 10/2/2014 1:38:39PM Page 1 of 1
SPRINGFIELD -
1 _:OREGON
811-SPR2014-02140
CITY OF SPRINGFIELD
225 Fifth Sl
Spnngfield,OR 97477
641-726-3753
w .springfieldacgov 445 HARLOW RD permitcenter@spdngfield-or.gov
RECEIPT NO: 2014002181 RECORD NO: 811-SPR2014-02140 DATE: 10/02/2014
Continuing Education Fee 224-00000-425606 - 2.50
Mechanical Permit fee (based on value of work) 224-00000-425604 1006 155.65
State of Oregon Surcharge (12% of applicable fees) 821-00000-215004 1099 18.68
Technology fee (5% of permit total) 100-00000-425605 2099 7.78
TOTAL DUE: 184.61
Credit Card Sunset Heating & Air
00513G
TOTAL PAID: 184.61
Mechanical Permit Application DEPARTMENT USE ONLY
srwiHer'ier.o L'
0 r 1 0 i Permit no. :��� O91 170
225 Fifth Street # Springfield, OR 97477 4 PH(541)726-3753 ♦ FAX(541)726-3689 '�'.� - Date: to �
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:
e1 to p
City:
$82,011
State:0P7�
ZIP:Q-7Lk (
Reference:
Taxlot.:
Up to 100k BTU/hr.
DESCRIPTION OF 1NORf(
$
Over 100k BTU/hr.
•,PROPERTY':OWNER '
Name:
'Z ao&ql
Address:
City;
$
I State:
ZIP:
Phone:AJ- I -
7 7 O 0
Fax:
E-mail:
$82.00
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 i%: _,"..'
Business name:
wkx�kV{ (�
Address: - L
n
City:
$10.00
State:
zllcn
Phone:
I
Fax: ct — M —cl �?g 2_
E-mail: (
e C c{ QL 6 G e,
CCB license no.:
U Fj
Print name:
(
Signature:
One to four outlets
440-2545-J (5/21/2014/COM)
SCHEDULE
_FEE
Residential "IQ
osf
), e8.
Totat ;
�. Ce6t:
First Appliance
$82,011
Furnace/burner including ducts and vents
Up to 100k BTU/hr.
$19.00
$
Over 100k BTU/hr.
ea ers sto es/ s
Unit heater
$19.00
$
Wood/pellet/gas stove/flue
$43.00
$
Repair/alter/add to heating appliance/
refrigeration unit or cooling system/
absorntions stem
$82.00
$
Evaporated cooler
$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 CFM 1
1 $12.00
$
Over 10,000 CFM 1
1
$22.00
$
Com ressor/absor tions stem/heat DUMD
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
$22.60
$
Coriimercial , " _
Enter total valuation of mechanical system
and installation costs $
Enter fee based on valuatiovvn of mechanical system, etc.
$
Mlscel)aneotis floor
Cost
ea'.
Total
'
Reinspection
$82.00
$
Specially requested inspections (pe
$82.00
$
Regulated equipment (unclassed)
$16.00
$
Each additional inspection: (1) 1
$82.00
$
'-' 'i ,< " . , .'. APFLICANT'_US'
..
(A) Enter subtotal of above fees (or enter set
minimum fee of $ 82.00)
jjr t w
$ 1�
(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): $
,
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