HomeMy WebLinkAboutPermit Mechanical 2003-4-10
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City of Springfield
Mechanical Permit
Status: Issued
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
PERMIT NO.: MEC2003-00022
ISSUED: 4/10/2003
APPLIED: 4/10/2003
EXPIRES: 10/10/2003
SITE ADDRESS: 1444 MAIN ST
ASSESSOR'S PARCEL NO.: 1703363203000
Springfield
TYPE OF WORK:
TYPE OF USE:
Remodel
Commercial
PROJECT DESCRIPTION: Suppression System
Fire Inspection Only
OWNER/APPLICANT: MECHANICAL CONTRACTOR:
POSEY ALLAN B
1446 MAIN ST STE A
SPRINGFIELD OR 97477
CLUB 1444
% LANDEROS INe
SPRINGFIELD OR 97478
CCB#
Expiration Date:
Descrintion
Amount Paid
Date Paid
Receiot Number
+ 10% Administrative Fee
+ 7% State Surcharge
-Issuance Fee-
Miscellaneous Mechanical
4.50
3.15
10.00
45.00
04/10/2003
04/1 012003
04/1 0/2003
04/10/2003
2200200000000000722
2200200000000000722
2200200000000000722
2200200000000000722
To Request an inspection call the 24 hour recording at 726-3769. All inspections requested before 7:00 a.m. will
be made the same working day, inspections requested after 7:00 a.m. will be made the following working day.
Reouired Insoections:
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 ofthe State of Oregon pertaining to the
work described herein. I further certify that only contractors and employees who are in compliance with ORS
701.055 will be used on this project. I further agree to ensure that all required inspections are requested at the
proper tim.e.1tllilN::"illiliJ"acllieJjsllislateadabl\tl'froJrtlth\iJstreet, and that the approved set of plans, if applicable, will
remain 0' '0 . teJRtmllcl1' i\lgl6:);f,,;'::'ciil)i\\ty~, 9TI C E'
ti 'cation C . ose rules are setfortt ';fiIS PF.r:MIT SH,(v.c-r.6c-G-.
~ . .. th'''"gh n6R Qo;?-O01. It)VI 7'.:<: ~'a>H1E-tf .~ORK
er <l5&RP.~J:~qn;a~ig!J!I.!\l~l{:OpieS of the rules b} dJTHO~ateJNUI:R THIS PERMIT IS NOT
. calling the center. (Note: the telel=ffllllf of I \jlvll'v1tNCED OR IS ABANDONED FOR
number for the Oregon Utility Notification J Y 180 DAY PER 10 D.
Center is 1-800-332-2344).
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.1773 :"I~in Street
Sprin::]{lelcl. OH 87~~.7~
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FOR: Ciub 1<!44
'j 444 Main Street
SprinqAeld, Or-91]On 97477
Sca19" Non-~
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Range Guard Wet Chemical
Fire Suppression System. Maciel RG-2.5G
25 Gallon Capacity
Flow Point Capacity: 8
Flow Points Used: 8
Springfield fire Marshal's Office
E1J(:J ~.. ..h.. <;l1hmiued information, these: plans appear consistent
with the minimum requiremcm s for Fire and Life Safety of the
v,),)(. -.u.;/ '..u c.rs :'1S adopted 1 y ordinance by the City of Spt"ingfiet4.
Review comments a Id Doted ex ~eptions are attached and on file at
-'t. City of Springf., Id Fire Mal s~al's office. Approval of submitted. .
n.. .. Si:i ~.. notn appro val of om" :""!1~)jve~ig,:!! 017e cO; by. tbe
l A9P'\!q;J./e> D ,te: '-!J . ~Revlewed by.....~K.~711ff
f$.. ~1,ri)-113",,<-< /
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QT'( NOULE VALUE I TOTAL
4 ,L\OP [ I 4
2 F 2 4
TOTAL I 8
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{,Jotes: System installed in ~ccordance with
Range Guard Technical Manl/al
PIN 27000 (U,L, EX2458) "101/, 21,199<1,
System ;:asted in accordance with
U L. Standarcllf:300.
:J"':!'Nn ::-'y: .}a
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
Line Items:
Job/Journal Number
MEC2003-00022
MEC2003-00022
MEC2003-00022
MEC2003-00022
Payments:
Type of Payment
Check
Paid By
Description
-Issuance Fee-
Miscellaneous Mechanical
+ 7% State Surcharge
+ 10% Administrative Fee
A-I FIRE PROTECTION
Receipt #: 2200200000000000722
Date: 04/10/2003
Received By
Check Number Confirm No
lkw
2514
Page I of I
4/1 0/2003
9:19:42AM
City of Springfield
Development Services Department
Public Works Department
Official Receipt
.
Amount Paid
10.00
45.00
3.15
4.50
Line Item Total:
$62.65
How Received
Amount Paid
In Person
.
Payment Total:
62.65
$62.65
cReceipt.rpt
, " CITY OF CJ~INGFIELD, OREGON 0
225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689
City Job Number ~ /11J7) "1 - [b027 Dale
o I & 2 Family Dwelling or Accessory 0 New Conslruclion
o Multi-Family 0 AdditionlAlterationlReplacement
Ql""Commercial/lndustrial 0 Tenantlmprovemenl
Job Address I'll/if ;11c.,;-' s?
Lot Block Subdivision
Project Name (' I t/h It-I/I t/
Description of Work/location on premises/special conditions
o
o
Demolition
Olher
Bldg No.
Tax Maprrax Lot
Suite No.
o
Property Owner
r::"'f~""'',.' /1. t/{YMIu-
1 &2 Family Dwelling, ..
SQFt
X $/SQ Ft
Value
Name
Mailing Address
City
Phone
State
Zip
New Dwelling Area
Garage/Carport Area
Other Structure Area
Total Value
Comme...ci.al/lndu.~lrial/llfulti:Family
SQ Ft X $/SQ Ft
= Value
Fax
Owner Representative
Phone
Fax
o ,Applicant
Name
Mailing Address
City
Phone
Existing Building Area
New Building Area
State
Zip
Fax
Total Value
o ,Arch(tect/Designer/E!!-gin.eer__,
Name
Address
Ex isting
New
City
Contact Person
Phone
State
Zip
Occupancy Group(s)
Cons\. Type(s)
Number of Stories
Fax
o
Conlra,,-tor(s) _
Contractor's Name
A -/ ;::; '" ,P /'nkJ, ~, /I
CCB#
/00'335
Expiration Date
/'-2'7.- /J J..
Phone #
7).6-7;(37
o R~sicJe_ntiCl!.Pr:ojecfs, ,.. .
Heat Source: Primary
Water Heater Range
Do you require any of the following for this project?
Over-width or Second Driveway 0 Yes 0 No
Temporary Power 0 Yes 0 No
Nolice: All contractors & subcontractors are required to be licensed with the Construction Contractors Board of the State of Oregon
under provisions ofORS 701 and mav be reQuired to be licensed in the iurisdiction where work is beinu performed.
I For Qffice Use Only
I PLAN CHECK FEE I
General
Plumbing
Mechanical
Electrical
o/Commcrcial/lndustrilli Projects
Has site review application been submitted?
DYes 0 No 0 NIA
If so, Name of Planner
Journal Number
Secondary
Energy Path
BUILDING
I
PERMIT
APPLICATION
I RCPT#
I DATE
I BY I
Shared Drivc(T:)fBuilding Fonns!Building. Pcmlit Application IO-02.doc