HomeMy WebLinkAboutPermit Mechanical 2019-11-14OREGON
Web Address: www.springfield-or.gov
Building Permit
Commercial Mechanical
Permit Number: 81 1-19-002374-MECH-O I
IVR Number: 811099355592
City of Springfield
Development and Public Works
225 Fifth Street
Springfield, OR 97477
54t-726-3753
Email Address: permitcenter@springfield-or.9ov
SPRINGTIELD
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Permit Issued: November L4, 2Ol9
TYPE OF WORK
Category of Construction: None Specified
Submitted Job Value: $303,715.00
Description of Work: Pharmacy Renovation- basement level
Type of Work: None Specified
JOB SITE INFORMATION
Worksite Address
1460 G ST
Springfield, OR 97477
Parcel
170336220460r
Owner:
Address
MCKENZIE WILLAMETTE
REGIONAL MEDICAL CTR
14400 METCALF AVE
OVERLAND PARK, KS
66223
LICENSED PROFESSIONAL INFORI{ATION
Busaness ilame
HARVEY & PRICE CO - Primary
DORMAN CONSTRUCTION INC
License
ccB
ccB
Lacense Number
77
68801
Phone
54r-746-L62L
541-984-0012
PENDING INSPECTIONS
Inspection
2999 Final Mechanical
2300 Rough Mechanical
Inspection Group
Mech Com
Mech Com
Inspection Status
Pending
Pending
SCH EDULING INSPECTIONS
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: 811099355592
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 will 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-OO1-OO1O through oAR 952-OO1-OO9O, you may obtain copies of the rules by calling the center at (5o3)
232-L947.
All persons or entlties performing work under this permit are required to be licensed unless exempted by ORS 7O1.O1O
(structural/Hechanical), oRs 479.54O (Electrical), and oRs 693.o1o-o20 (Plumbing).
printed on: LLI$trg page 1 of 2 c:\myReports/reports//production/01 STANDARD
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Permit Number: 811-19-OO2374-MECH-O1 Page 2 of 2
Fee Description
Technology Fee
Commercial mechanical permit (based on mechanical job value)
State of Oregon Surcharge - Mech (12o/o of applicable fees)
Printed on: 11/14l19
Quantity
Total Fees:
Fee Amount
$104.s1
$2,090.14
$2s0.82
$2,445.47
Page 2 of 2 C: \myReports/reports//production/01 STANDARD
PERMIT FEES
SPRINGFIELD
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Transaction Receipt
81 I -1 9-002374-MECH-01
Receipt Number: 472993
Receipt Date= 11114119
City of Springfield
Development and public Works
225 Fifth StreetSpringfield, OR 97477
541_726_3753
permitcenter@sprin gfield_or. gev
ORTGON
www.springfi eld-or. gov
Worksite address: 1460 G ST, Springfield , OR 97477
Parcel: 1703362204601
Fees Paid
Transaction date
11t14t19
11t14119
11t14t19
Units
1.00 Ea
1.00 Ea
1.00 Automatic Technology Fee
Description
Commercial mechanical permit (based on
mechanical job value)
State of Oregon Surcharge - Mech (12o/o ol
applicable fees)
Account code
224-00000-425604- 1 03 1
821 -00000-21 5004-0000
20 4 -00 00 0 -425605 -00 0 0
Fee amount
$2,090.14
$250.82
$104.51
Paid amount
$2,090.14
$250.82
$104.51
Payment Method Credit card authorization:
314143
Payer: DORMAN CONSTRUCTION INC Payment Amount:$2,445.47
Cashier: Katrina Anderson Receipt Totai:$2,445.47
Printed: 'l'll'14l'19 11:37 ail Page 1 of I Fl N_TG nsaction Receipt_pr
Ir
Mechanical Permit Application
SPBlitotllLo
225 Fifth Street o Springfield. OR 97477 . PH(541)726-3753 . FAX(541)726-3689
This permit is issued under OAR 9f 8-440-0050. Permits expire if work is not started within lEO days of issuance or if work is
suspended for 180 days.
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DEPARTMENT USE ONLY
Permit no
Date 4
CATEGORY OF CONSTRUCTIO,.I FEE SCHEDULE
E Residential E Governnrent tCommercial Residential Qty Cost
ea.
Total
cost
JOB SITE INFORMATION AND (OCETION First Anoliance s102.00 $
Furnace/burner including ducts and vents
Job site address Up to l00k BTU/h,$23.00 $city$ff.{.State: &Y ZW Ovcr l00k BTU/hr.$26.00 s
Reference Taxlot.Heaters/stoves/vents
Unit heater $23.00 $DESCRIPTION OF WORK
Wood/pellet/gas stove/fl ue $54.00 $
Evaporated cooler $19.00 $\Vent fan with one duct/appliance $13.00 $
PROPERTY OWNER Hood with exhaust and duct $r 9.00 $
Narle:t lou,yad.One to four outlets s! Aue Additional outlets (each)15.00 $
stlt., K5 nP:ld[rz'L4 Air-handline units. includins ducts
Up to 10,000 CFM ll 5.00 $
Phorre:Fax Over 10,000 CFM i26.00 $
E-mail Comnressor/ahsorntion svstem/heat numn
$This irrstallation is being made on properry owned by me or a
member of my immediate family, and is exempt from licensing
requirements under ORS 701.010.
Signature:
Up to 3 hp/100k BTU $23.00
Up to l5 hp/500k BTU $41.00 $
Up to 30 hp/l.000 BTU $61.00 $
Up to 50 hp/l,750 BTU $78.00 s
Over 50 hp/I,750 BTU $I32.00 $CONTRACTOR INSTALLATION Incinerators
Domestic incinerator $26.00 $
Address:
I
tJ.ld{/Commercial
City: fg1>1!tr p State: $y'TP,q7+3 Enter total valuation of mechanical svstem q-
and installation costs S 3A? .1 l€ '-
Fax:Enter t'ee based on valuation of mechanical system, etc.$
E-mail:lMiscellaneous fees Cost
ea.
Total
cost
CCB licerfse'no.
(1-l ^ r't'j
Reinspection il02.00 s
Print name
Signature:
Specially requested inspections (per il02.00 $
Regulated equiprnent (unclassed)t19.00 s
Each additional inspection: (l )ll 02.00 $
DEPARTMENT USE
(A) Enter subtotal ofabove fees (or enter set
minimum fee of $ 102.00)$
(B) Investigative fee $
(C) Enter l2oZ surcharge (.12 x [A+B])$
(D) Seismic fee, lYo (.01 x [A])$
(E) Technology Fee (5% of [A])$
TOTAL fees and surcharges (A through E):s
Last edited 7/l /2019 BJones
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