HomeMy WebLinkAboutPermit Mechanical 2010-8-13
225 Fifth Street. Springfield, OR 97477 . PH(541)726-3753 . FAX(541)726-3689
Date: g-I3-lo
Mechanical Permit Application
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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.
First A liance
urnacelburner including ducts and vents
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 701.010.
Signature:
Up to tOOk BTU/hr. $
Over lOOk BTU/hr. $
Heaters/stoves/vents
. Unit heater $17.00 $/
Wood/pellet/gas stove/ . e $38.00 $
Repair/alter/add to heating appliance/
refrigeration unit or cooling system! Ifj" $58.00 $
absorption system r.~; if-
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 $
Additional outlets (each) $
Air-handling units, including ducts
Up to 10,000 CFM
Over 10,000 CFM
Com ressor/absor tions stem/heat urn
Up to 3 hp/IOOk BTU $17.00 $
Up to 15 hp/500k BTU $29.00 $
Up to 30 hp/I.OOO BTU $43.00 $
Up to 50 hp/I,750 BTU $57.00 $
Over 50 hp/I,750 BTU $95.00 $
Incinerators
E-mail:
Signature:
Reinspection
Specially requested inspections (per hr.)
Regulated equipment (unclassed)
Each additional inspection: (I)
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440-2545-) (11/0S/COM)
(A) Enter subtotal of above fees (or enter set
minimum fee of $ 79.00)
(B) Investigative fee (equal to [A])
(C) Enter 12% surcharge (.12 x [A+B])
(D) Seismic fee. 1% (.01 x [A])
(E) Technology Fee (5%0f[A])
TOTAL fees and surcharges (A through E):
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',", OREGON
TRANSACTION RECEIPT
CITY OF SPRINGFIELD
225 Fifth 51
Springfield,OR 97477
541-726-3753
www.ci.springfield.or.us
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pennilcenter@ci,springfield.or.us
RECEIPT NO: 2010000057 RECORD NO~'.8h-sPR2010-00058 DATE: 08/13/2010
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Air Handling Unit up to 10,000 cfm 224-00000-425604 $17.00
Heat pump 224.00000-425604 $17.00
First Appliance Fee 224-00000-425604 $79.00
State of Oregon Surcharge (12% of applicable fees) 821-00000-215004 $13.56
Technology fee (5% of permit total) 100-00000-425605 $5.65
TOTAL DUE: $132.21
IH!AynilENT_.TYPE'~-ii,F1AYbR';'::::C_I\S8.'-ER ~MAi;B:ADgiti0;,:COMMENTS;':-:;_.-"::'-'." ';.'i' "Ii., AMOUNT PAID-.'~; -- .;"J
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Check PACIFIC AIR COMFORT INC,;>,,'--,' ;,: ,. $132,21
023608
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