HomeMy WebLinkAboutPermit Mechanical 2019-01-29oitEG0ii
Web Address: www.springfield-or.gov
Building Permit
Residential Mechanical
Permit Number: 81 1 -19-000191 -MECH
IVR Number: 81'1079909656
City of Springfield
Development and Public works
225 Fifth Street
Springfield, OR 97477
54t-726 3753
Email Address: permitcenter@springfreld'or.gov
SPRINGFIELD
rt
Permit lssued: January 29,2019
TYPE OF WORK
JOB SITE INFORMATION
Worksite address
2,195 OTTO ST
Springfleld, OR 97477
Parcel
1703244306100
Owner:
Address:
BARRETT FRANK &
LEONA
2195 OTTO ST
SPRINGFIELD, OR 97477
LICENSED PBOFESSIONAL INFORMATION
Business name
NiICKEY LAWRENCE STAFFORD -
Primary
License
CCB
License number
171110
Phone
541,359-5035
PENDING INSPECTIONS
lnspection
2999 Final Mechanical
2140 Pellet, Gas, Fireplace or Wood Stove
lnspection status
Pending
Pending
SCHEDULING INSPECTIONS
Various inspeclions are minimally required on each project and often dependent on lhe scope of work. Contact the issuing
.iurisdiction indicated on the permil to delermine required inspeclions for this project.
Schedule or track inspections at www.buildingpermits.oregon.gov
Schedule by phone call 1-888-299-2821 use IVR number: 811079909656
Schedule using the Oregon ePermitting lnspeclion App, search "epermitting" in the app store
Permib must bo posted in clear view on tho \f,orksite. Pqrmits expirc if work is not started within 18O Oays of issuance or if work issuspondod for 180 Days or longor doponding on ths issuing agoncy's policy.
All p.ovisions of laws and ordinances governing this type of work will be complied with whethor spscifiod hercin o. not Granfing of
a Perlnit doos not prcsum6 to give authority to violate o. cancel tho provision8 of any othor state or local law .egulating qonstruction
or th6 psrformancs of consbuction.
ATTENTION - CALL BEFORE YOU DIG: Orogon law roquircs you to follow rules adopted by the Orogon Utitity Notirication Csntsr.
Thoso rules arc 3et forth in OAR 952{01-oolo through oAR 952-0ol-oo9o. You may obtain copies of the rulss by calling the Csnter at(877) 66E-,1001 or dial 8ll.
All peEons or entitios t,erforming work und.r this permit a.e rcqui.sd to be licensed unloss oxempted by ORS TOi.OlO
(StructuraUMechanical), ORS 479.540 (Etectricat), and ORS 693.010.o20 (ptumbing).
Prinied onr 1/29119 Page 1 of 2 std_Burldrngperm(_pr
Category of Construction: Single Family Dwelling Type of Work: New
Submitted Job Value: $0.00
Description of Work: lnstallation ofwood burning insert and chimney liner
lnspection group
Mech Res
Mech Res
Permit Number: 8'l'l-19-000191-MECH Page 2 of 2
Fee Description
Technology Fee
Balance of minimum permlt fees - mechanical
Gas or wood fireplace/insert
State of Oregon Surcharge - Mech ( 12olo of applicable fees)
Quantity
Total Fees:
Fee Amount
$4.9s
$47.00
$52.00
$11.88
$ 1 1s.83
1
Pnnled on 1/29119 Page 2 ol2 sld,BuildingPermit_pr
PERMIT FEES
SPRINGFIELD
,b
OREGO'{
www.sPringfield-or. gov
Worksite address: 2195 OTTO ST, Springtield, oR97477
Parcel: 1703244306100
Development and Public Works
225 Fifth Street
Springfield, OR 97477
541-726-3753
permitcenter@springfield-or, gov
Transaction Receipt
81 1-1 9-000191 -MECH
Receipt Number: 469257
Receipt Date: 1/29/19
City of Springf eld
Transaction date
1t29119
1t29t19
1t29t19
Units
1.00 Ea
1.00 Automatic
1.00 Ea
Account code
224- 00000 - 425604- 1 03 1
224 - 00000 42s604- 1 031
82 1 -00000-2 1 5004-0000
Fee amount
$52.00
$47.00
$1 1.88
Paid amount
$52.00
$47.00
$11.88
Fees Paid
Oescription
Gas or wood lireplace/insert
Balance of minimum permit fees - mechanical
State of Oregon Surcharge - Mech (12% of
applicable fees)
Technology Fee1t29t191.00 Automatic 1 00-00000-425605-0000 $4.95 $4.95
Payment lvlethod: Cash Payer: Mickey Stafford Payment Amount $115.83
Cashier: Katrina Anderson Receipt Total:$r15.83
Printed 1/291191155am Pege 1 of 1 Fl N_TransacllonReceipt_pr
Crrv or SpnrNcFrELD, OnrcoN
Mechanical Permit Ap plication
225 Fifth Streel . Springfield, OR 9747'7 . PH(541\'726-3153 . FAX(54I )726-3689
DEPARTMENT USE ONLY
,11-port t
Date \ lzq l1&
This permit is issued under OAR 918-440-0050. Permits expire if work is Dot started withitr 180 davs of issuance or if work is
suspended for 180 days.
E-mail:
FEE SCHEDULE
Residential Qty.Cost
e3.
Total
cost
First Appliance s99.00 s
Furnace/burner ircludidg ducts and vetrts
Up to 100k BTlr-/hr s22.00 $
525.00 5
Heaters/sloves/venfs
s22.00 $
Wood/pellet/gas stove/fl ue s52.00 s\2-
Evapomted cooler s18.00 5
Vent fan with one ducVappliance .$13.00 $
Hood with exhaust and ducl s18.00 5
Gas piping
One to four outlets S8.48
Additional outlets (each)s5.30
Air-haodling units, including ducts
Up to 10,000 CFM $15.00 s
Over 10.000 CFM s25.00 S
Comoressor/absorDtioD syst€rl/heat DumD
Up to 3 hp/l00k BTU $22.00 s
Up to 15 hp/500k Bl -n s40.00 s
Up to 30 hp/l,000 BTU ss9.00 $
Up to 50 hp/l,750 BTU $76.00 S
Over 50 hp/1,750 BTU s128.00 s
lncitrerators
Domestic incinemtor s25.00 S
Commercial
Enter total valuation ofmechanical system
and insrallarion costs $
Enter fee based on valuation ofmechanical system, etc S
Miscellaneous fees Items Cost Total
cost
Reinspeclion i99.00 S
Special)1' requested inspections (per s9s.00 $
Regulated equipment (unclassed)s18.00 S
Each additional iDspeclion: (l ).$99.00 5
DEPARTMENT USE
(A) Enter subtotal ofabove fees (or enter set
minimum fee of $ 9AQ0),q1
(B) lnvestigative fee S
(C) Enter l2% surcharge (.12 x [A-B])S
(D) Seismic fee, 19; (.01 x [A])$
(E) Technolog) Fee (5% of[A])S
TOTAL fees and surcharges (A through E):l $ ll ,. Y,
$
$
Fax: <--
f/,e
CATEGORY OF CONSTRUCTION
sidemial ! Govemment I Commercial
JOB SITE INFORMATION AND LOCATION
Job site address
Cit-y State ZIP
Re Ta>(lot.
DESCRIPTION OF WORK
PROPERTY R
Name <?
Address
City State ZIP
Ph 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 undfl ORS 701.010.
Signature:
CONTRACTOR INSTALLATION
Address:
Cit_"S ZlP
Print name
Sign
l-asl edited 7i1,12018 blones
Permit no.:
Over l00k BTU,4r.
Business name:
CCB license no.:
Unit heater