HomeMy WebLinkAboutPermit Mechanical 2019-09-04Building Perm it
Commercial Mechanical
Permit Number: 811-19-002040-MECH
IVR Number: 811040972514
City of Springfield
Development and Public Works
225 Fifth Street
Springfield, OR 97477
541-726-3753
Web Address: www.springfield-or.gov Email Address: permitcenter@springfield-or.gov
Pe rm it Is s u e d : September 04, 2019
C a te g o ry o f C o ns tructio n : Commercial
S u b m itte d Jo b V alu e : $4,800.00
D e s c rip tio n o f W o rk : Ductless minisplit
Typ e of W o rk: New
W o rk site A d d res s
720 35TH ST
Springfield, OR 97478
Parcel
1702312102601
O w ner:
A ddress:
BLACK LABEL LLC
79 CENTENNIAL LOOP
EUGENE, OR 97401
B u s in e s s N a m e
KURTIS ANTHONY STEWART -
Primary
Licen se
CCB
License N um ber
225908
Phone
541-653-4145
In s p e ctio n
2999 Final Mechanical
2100 AC/Furnace/Heat Pump/HVAC
In spection G roup
Mech Com
Mech Com
Inspection Status
Pending
Pending
Various inspections are minimally required on each project and often dependent on the scope of work. Contact
the issuing jurisdiction indicated on the permit to determine required inspections for this project.
Schedule or track inspections at www.buildingpermits.oregon.gov
Call or text the word "schedule" to 1-888-299-2821 use IVR number: 811040972514
Schedule using the Oregon ePermitting Inspection App, search "epermitting" in the app store
Permits expire if work Is not started within 180 Days of issuance or If work Is suspended for 180 Days or longer depending on
the Issuing agency•s policy.
All provisions of laws and ordinances governing this type of work wlll be complied with whether specified herein or not.
Granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law
regulating construction or the performance of construction.
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 at (503)
232-1987.
All persons or entitles performing work under this permit are required to be licensed unless exempted by ORS 701.010
(Structural/Mechanical), ORS 479.540 (Electrical), and ORS 693.010-020 (Plumbing).
Printed on: 9/4/19 Page 1 of 2 C:\myReports/reports//production/01 STANDARD
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Mechanical Permit Application
CITY OF SPRINGFIELD, OREGON
225 Fifth Street+ Springfield, OR 97477 + PH(541)726-3753 + FAX(541)726-3689
DEPARTMENT USE ONLY
Permit no.: ,Jt,-;Q().00"{ 0
Date: °I 1 '--( l l 9
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
D Residential I D Government I M Commercial
JOB SITE INFORMATION AND LOCATION
Job site address: 1-Z..o ~ s- \'-\ S\-tt<!.\-
City: sf f', -n_'\fl l \~ I State: O ~ · I ZIP: ql41'i
Reference: I Taxlot.:
DESCRIPTION OF WORK
i-lv~ ~iV\~5 f\,\ '() v...cA\t>s .
PROPERTY OWNER
Name: f:,, fN''J \,J •.• \ \(.t,'C'•
Address: 71...0 '1~-\\..._ <ii\
City: S~N~~\t,\~ l State: OR I ZIP: <\141i·
Phone: 'Slll- 1S'l - l\-oU I Fax: - _I -
E-mail: 0 Q. te .. \<. , "¥S4 @ ~M .f\\ \ · U,.--'\ -
This installation is being m~e 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: Pre..os,o'1\ \-t l~, "~ .; .A i i' •
Address: '34l~b <e~vtY \oil/ r.J... ..
City: E" ~tht l State: 0 R j ZIP: C\14:0S'
Phone: - .. - S1.\\-~S;- ~\\.\-S-j Fax: ~ - - /
E-mail: C) R \>n .. c:,;5, 1i" ~ ~n,,_,\. u:> e»:
'1, 1..S"t\ot · -
CCB license no.:
Print name: Kv..~ $~ \,J~('-\-
Signature: ?~ -
FEE SCHEDULE
Residential Qty. Cost Total
ea. cost
First Annliance i99.00 $
Furnace/burner ineludlnz ducts and vents
Uo to 1 0Ok BTU/hr. $22.00 $
Over 100k BTU/hr. $26.00 $
-- L--~-
Unit heater $22.00 $
Wood/pellet/gas stove/flue $62.00 $
Evaporated cooler $18.00 $
Vent fan with one duct/appliance $13.00 $
Hood with exhaust and duct $18.00 $
Gas oloinz
One to four outlets $8.48 $
Additional outlets (each) $6.30 $
Air-handlina units. includlna ducts
Up to 10,000 CFM $16.00 $
Over 10,000 CFM $26.00 $
Comoressor/absorotion svstem/heat numn
Up to 3 hp/1 00k BTU $22.00 $
Up to 15 hp/500k BTU $40.00 $
Up to 30 hp/1,000 BTU $69.00 $
Up to 50 hp/1, 750 BTU $76.00 $
Over 50 hp/1,750 BTU $128.00 $
Incinei ~
Domestic incinerator $26.00 $
Commercial
Enter total valuation of mechanical system
and installation costs $ 4,, 100
Enter fee based on valuation of mechanical system, etc. $
Miscellaneous fees Items Cost Total
ea. cost
Reinspection $99.00 $
Specially requested inspections (pe $99.00 $
Regulated equipment (unclassed) $18.00 $
Each additional inspection: (1) $99.00 $
DEPARTMENT USE
(A) Enter subtotal of above fees ( or enter set
minimum fee of $ 99.00\ $
(B) Investigative fee $
(C) Enter 12% surcharge (.12 x [A+B]) $
(D) Seismic fee, 1%(.01 x [A]) $
(E) Technology Fee (5% of [A]) $
TOT AL fees and surcharges (A through E): $ Lo~.'?
Last edited 7/l/2018 bjones