HomeMy WebLinkAboutPermit Mechanical 2010-4-1
Mechanical Permit Application
225 Fifth Street. Springfield, OR 97477 . PH(541)726-J75J . FAX(541)726-J689
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Penn it no.: (J/O-40S-
Date: 4 , 10
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.
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o Residential 0 Government 0 Commercial
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Job site address: '3 (" ~o ;vlf/ I
City: S. F"F uJ State: V~ ZIP: ')'7 L; '7 f
Reference: Taxlot.:
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Name: 6~~ ~.'\;-M..€"5
Address: )S62S- Vt::
City: VAS I rIA.
Phone:
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 under ORS 701.0 I O.
Signature:
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Signature: /
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440-2545-) (l1/08/COM)
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!;Resldentlal t1~' "'''~''''''''''''"''''I):\l'';it \'~~ea.,:-~~t
~,-\, :'""~"''''''''"":",,,,:~:,~',,~;;,,'4'{YJ.l11:'$,'~'':'l~\'}}'~':'iZj, <.~;~d~ '~y:cost,~i-'i';
First Annliance ~ $79,00 $-'~
Furnace/burner including ducts and vents
Upto lOOk BTU/hr. $17.00 $
Over lOOk BTU/hr. $20,00 $
Heaters/stoves/vents
Unit heater $17.00 $
Wood/pellet/gas stove/flue $38.00 $
Repair/alter/add to heating appliance/
refrigeration unit or cooling system! $58.00 $
absorption system
Evaporated cooler $13,00 $
Vent fan with one duct/appliance vent $9.00 $
Hood with exhaust and duct $13,00 $
Floor furnace including vent $58.00 $
Gas piping
One to four outlets $7.00 $
Additional outlets (each) $4.00 $
Air-handling units, including ducts
Up to 10,000 CFM I I $11.00 I $
Over 10,000 CFM I I $20.00 $
Comnressor/absorption svstem/heat oump
Up to 3 hp/1 OOk BTU $17.00 $
Up to IS hp/500k BTU $29,00 $
Up to 30 hp/I,OOO BTU $43,00 $
Up to 50 hp/1 ,750 BTU $57,00 $
Over 50 hp/1,750 BTU $95.00 $
Incinerators
~stiC incinerator I $20.00 $
'Pi '."',."Ji.!! -.
Ente: total v~luation ofmeChaniC?18~terfh::-; $(0)
and installatIOn costs $ ~ . ::r-
Enter fee based on valuation of mechanical system, etc, I $ <;'X
t,M"'ill.'4't,'0:s'l':r';.1'$;'Z:~i. ::;s*':":-'s;;.;r;.r0,;'f;iTi'",,~_,j;iS'#i~J~'}:;l,'j iti~~ ",::.:"C'l'" '" T t'l '
0M Iscella neous:.fees~i,y,j'~',;\'B;if!,!,l~ ~~>,9,~;S?-.: ";,~ ,0_ a ~:;,l
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Reinspection $58.00 $
Specially requested inspections (per hr.) $58.00 $
Regulated equipment (unclassed) $13.00 $
Each additional inspection: (1) $58.00 $
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(A) Enter subtotal of above fees (or enter set ~sf
minimum fee of $ 79.00) $
(8) Investigative fee (equal to [A]) $
(e) Enter 12% surcharge (.12 x [A+B]) $ ~'
(D) Seismic fee, 1%(.01 x [A]) $
(E) Technology Fee (5% of [A]) $ ~, 'j
TOTAL fees and surcharges (A through E): $~
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Status
Issued
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CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM201O-00405
ISSUED: 04/01/2010
APPLIED: 04/01/2010
EXPIRES: 10/01/2010
VALUE: $ 2,000.00
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 3650 MAIN ST
ASSESSOR'S PARCEL NO.: 1702314202501
Springfield TYPE OF WORK: Mechanical Only
TYPE OF USE: Alteration Commercial
PROJECT DESCRIPTION: Install Type I hood-electrical contractor will apply for permit for circuit alteration
Owner:
Address:
GREEAR JAMES D
35625 NE WASHOUGAL RIVER RD
WASHOUGAL WA 9867IATTENTION: Oregon law requires you,t,o
18119'" ....In~ 'Jnnnton h~, thp. OrAaon Utllltv
rnog1~~~~rth
0090. You may obtain caples 0 e ru e ~
Contractor calling the center. (Note: the t~llll~ll
MARICLE STMNAlti611:Utm Oregon Utility Nc;lijif~on
h6\'rDI'NG:INF~~~~8il~N ~
Expiration Date
04/07/2010
Phone
541-935-0461
Contractor Type
Mechanical
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
# of Stories:
Height of Structure
Type of Heat:
Water Type:
Range Type:
Energy Path:
NOTlCE;'prinkled Buildin
Tille"
Lot Size:
Sq Ft I st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
IF THE'WORK Occupant Load:
REQUIRED PARKING
Total:
Handicapped:
Compact:
Front yard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
AI
COMMENCED
ANY 180lfiVeYIP~BWP.
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
I PUBLIC IMPROVEMENTS ~
Street Improvements:
Storm Sewer Available:
Special Instruction:
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Sidewalk Type:
Downspouts/Drains:
Notes:
I Valuation Description I
Description
Type of Construction
$.Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Page I of 2
Status
Iss u ed
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CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2010-0040S
ISSUED: 04/01/2010
APPLIED: 04/01/2010
EXPIRES: 10/01/2010
VALUE: $ 2,000.00
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Total Value of Project
Fees Paid ~
Fee Description
+ 12% State Surcharge
+ 5% Technology Fee
Mechanical- Value
Amount Paid
Date Paid
Receipt Number
$6.96
$2.90'"
$58.00
4/1110
4/1110
4/1110
2201000000000000305
220]000000000000305
2201000000000000305
Total Amount Paid
$67.86
I Plan Reviews ~
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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
work day.
I ReQuired InsDections ~
Rough Mechanical: Prior to Cover
Final Mechanical: When all mechanical work is compl~te.
By signatnre, I state and agree, that 1 have carefully. examined the completed application and do hereby certify that all
information hereon is true and correct, and] further certify that any and all work performed shall be done in accordance with
the Ordinances of the City of Springfield alld the Laws of tbe State of Oregon pertaining to the work described herein, and
that NO OCCUP ANCY 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 ellsure tbat all required inspections are requested at the proper time, that each address is readable from lhe
street, that the permit card is located at the fronl ofthe property, and the approved set of plans will remain on the site at all
timJ=/ictiO~.
Owner or Contractors Signature
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Date
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Pa2e 2 01'2
2~5 FiftlI Street
Springfield, Oregon 97477
541-726-3759 Phone
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City of Springfield Official Receipt
Development Services Department
Public Works Department
RECEIPT #:
2201000000000000305
Date: 04/0112010
2:42:31PM
Job/Journal Number
COM20 I 0-00405
COM20 I 0-00405
COM20 I 0-00405
Payments:
Type of Payment
CredilCard
cReceintl
Description
Mechanical- Value
+ 12% State Surcharge
+ 5% Technology Fee
Paid By
DENNIS MARICLE
Check Number
'.-j'
Received ~Y' Batch Number
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Page I of I
Item Total:
Authorization
Number How Received
Amount Due
58.00
6.96
2.90
$67.86
Amount Paid
420435 In Person
Payment Total:
$67.86
$67.86
4/1/20 I 0