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Home My WebLink AboutPermit Mechanical 2011-1-5 . CITY OF SPRINGFIELD 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 www.ci.springfield.or.us Building I Commercial Permit PERMIT NO: 811-SPR2010-00914 IVR Number: 811169573105 permilcenler@ci.springfield.or.us PROJECT STATUS: STATUS DATE: Issued 01/05/2011 ISSUED: APPLIED: 01/05/2011 12/16/2010 EXPIRES: VALUE: 07/04/2011 $2,000.00 SITE ADDRESS: 470 S 2ND ST, Springfield, OR 97477-5308 ASSESOR'S PARCEL NO: 1703353300500 SCOPE: Mechanical Only WORK INVOLVED: New TYPE OF STRUCTURE: Industrial PROJECT DESCRIPTION: (2) New Boilers in existing boiler room building. OWNER: ADDRESS: HEXION SPECIALTY CHEMICALS INC 180 E BROAD ST COLUMBUS OH 43215 Phone Number: CONTRACTOR INFORMATION ~ Contractor Type Mechanical Contractor Contractor Name EASTERN OREGON MACHINE INC Lie Type CCB lie No 167755 Lie Exp 12f29/2011 Phone 541-564-2607 # of Units: o BUILDING INFORMA TION ~ # of-Stories: Height of Str~cture: Type of Heat: Water Type: Range Type: Hazmat: No Lot Size: Sq Ft1 st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage: Sq Ft Carport: Sq. Ft Other: 0 Occupancy Loa"d: Electrical Specialty Code Edition: 2008 Springfield Fire Code Edition: 2010 _, SI J8lU88 .1......8Z-Z88-008 > . U Mechanical Specialty Code Edition: 2010 A\I\I\n u068JO 84l JO! J8qwn . uOll1301li\ON, , ) 80 e4l 6U1\1130 Municipal J Development Code: UO' 'deI8\ 84l :8l0N 'J8lU . .. 600 8 ~ d UlBlQO A13W nOA 0 Plumbing Specialty Code Edition: Aq S81nJ 84l!0 S81 00. _ 00-Z96 tlYO U! . Residential Specialty Code Edition, ~00-Z96 tlYO 46noJ4l 0 ~'~~lJ88 UOI\1301lIl0N l80 a'" S81nJ 8s041 . I Structural Specialty Code Edition: LllJO! '2 lO "l Aq p8ldop13 salOJ MO\lO t linn llnlla.l() 8'-1 _........11 Site Information ot ~O^ seJ!nba.l MBI UOUtUU '\\iUI..1..1 ~.............. # of Bedrooms: Sprinkled Building: No Fire Alarms: No Energy Path: Engineered Fill: Fill Volume: Flood Hazard Area: Land Hazard Area: Retaining Wall: Soils Report Required: ".."\Il"". ..:: .ur.. IRE IF THE WORK tHIS PERMIT SHAL~ ~~S PERMIT IS NOT AUTHORIZED UNDE ANDONED FOR COMMENCED OR IS AB ANY 180 DAY PERIOD. Springfield Building Permit 1/5/2011 9:14:25AM Page 1 of 5 www.cLspringfield.or.us CITY OF SPRINGFIELD Building I Commercial Permit PERMIT NO: 811-SPR2010-00914 IVR Number: 811169573105 225 Fifth SI Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 permitcenter@ci.springfield.or.us PROJECT STATUS: STATUS DATE: Issued 01/05/2011 ISSUED: APPLIED: 01/05/2011 12/16/2010 EXPIRES: VALUE: 07/04/2011 $2,000.00 SITE ADDRESS: 470 S 2ND ST, Springfield, OR 97477-5308 ASSESOR'S PARCEL NO: 1703353300500 SCOPE: Mechanical Only WORK INVOLVED: New TYPE OF STRUCTURE: Industrial PROJECT DESCRIPTION: Frontyard Setback: Interior Setback: Sideyard Setback: Rearyard Setback: Solar Setback: (2) New Boilers in existing boiler room building. DEVELOPMENT INFORMATION I Overlay Dist: # Street Trees Reqd: Paved Drive Reqd: % of Lot Coverage: Highest point on structure to north property line: REQUIRED PARKING Total: Handicapped: Compact: PUBLIC IMPROVEMENTS I Street Improvements: Storm Sewer: Storm Sewer Available: Speciallnstructon: Subdivision Accepted: Notes: Sidewalk Type: .>- DownspoutfDrains: Valuation Description ~ Description Tvoe of Construction Unit Amount Unit Tvoe Unit Cost Value FEES PAID I Descriotion Mechanical Plan Review Fee State of Oregon Surcharge (1,2% of aPE!~~able feest, Technologt!:e (5% of permit total) Backflow pre venter Balance of Minimum Plumbing Permit:-ees Structural Plan Review Fee Commercial Mechanical Permit fee (based on value of work) Building Permit Fee Structural Plan Review Fee Commercial Total Amount Paid Amount Paid $787.69 $392.01 $163.34 $19.00 $39.00 $27.84 $3,150.75 $58.00 $9.86 $4,647.49 Date Paid Reciot # 12/16/2010 2010001068 01/05/2011 2011000020 -"---'_"-,,'_0","_'-"-'-"'-". 01/05/2011 2011000020 .",-~~'.*_...., ~ ',-- 01/05/2011 2011000020 01/05/2011 2011000020 01/05/2011 2011000020 01/05/2011 2011000020 01/05/2011 2011000020 01/05/2011 2011000020 Springfield Building Permit 115/2011 9:14:25AM Page 2 of 5 SP..~.I~..G_.FIE.~ ~.,\" I'i{" clg, <j:;\ ~REGON CITY OF SPRINGFIELD 225 Fifth SI Springfield,OR 97477 Phone 541-726-3753 Inspection Phone: 541~726-3769 Fax: 541-726-3676 www.ci.springfield.or.us Building I Commercial Permit PERMIT NO: 811-SPR2010-00914 IVR Number: 811169573105 permitcenler@ci.springfield.or.us PROJECT STATUS: STATUS DATE: Issued 01/05/2011 ISSUED: APPLIED: 01/05/2011 12/16/2010 EXPIRES: VALUE: 07/04/2011 $2,000.00 SITE ADDRESS: 470 S 2ND ST, Springfield, OR 97477-5308 ASSESOR'S PARCEL NO: 1703353300500 SCOPE: Mechanical Only WORK INVOLVED: New TYPE OF STRUCTURE: Industrial PROJECT DESCRIPTION: (2) New Boilers in existing boiler room building_ Plan Review I Deoartment Initial Review Received Due Date Completed 12/22/2010 12/22/2010 12/22/2010 Result Approved Reviewer David Bowlsby Structural Review 12/22/2010 12/22/2010 12/23/2010 Add'llnfo Required Kip Kaufman :-___-___~~-- ""l"""~"." ~. , '~-.~'--'-'~-~'- -y-.:~.~.._-,......--....,--~---- -_._~- ~_.. ri~b:e;i:~s;' ~i:~~':~~cs;i~::u1b2~;~~%) ~~i~,JI~:~~2cO~~~~~9~i~~~::i~,,'~ePI~~t'~~~~~~~j~~~e"-6~le~"i'~:t~~:::~~o~:~r~ b~~I~l~g~ ,p;r ., ,',,' - .." :"'__,"",..__,,:,',''':, ------','"'''-,-_~",;,,,,;;'',,~,:''',0':,~,",,,,,,,,'',,--,,'_,i,',,:%:,,,'J,,,{,,,;-,,,',_f,,,,;;'.-~..,,,,'__ "".<,','_"'~ '.,';- '" -" ,iii,'"" /--", ~'"1- " ClJy:ot$p1iQgflel<L~uildingJ~!?~Exair!j!LelJ$,ip.JS2LJJ!Il~Q,:!b.~.&9.[I.~tJj'yj!ding'~i~[ct~:J_;g_~C;!::ip~.Qgy:~~o'fire:re~ew.reglJJ!~s!.<.:.~::~' " Structural Review 12/22/2010 12/22/2010 01/04/2011 Add'J Info Required Kip Kaufman Comments: Signed Special Jnspection Form Structural Review 12/22/2010 12/22/2010 01/05/2011 Approved Kip Kaufman Springfield Building Permit 1f5/2011 9:14:25AM Page 3 of 5 5P:~~~...~L~ L~ti1 ~OREGON www.ci.springfield.or.us CITY OF SPRINGFIELD Building I Commercial Permit PERMIT NO: 811-SPR2010-00914 IVR Number: 811169573105 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspeclion Phone: 541-726-3769 Fax: 541-726-3676 permitcenler@ci.springfieId.or.us PROJECT STATUS: STATUS DATE: Issued 01/05/2011 ISSUED: APPLIED: 01/05/2011 12/16/2010 EXPIRES: VALUE: 07/04/2011 $2,000.00 SITE ADDRESS: 470 S 2ND ST, Springfield, OR 97477-5308 ASSESOR'S PARCEL NO: 1703353300500 SCOPE: Mechanical Only WORK INVOLVED: New TYPE OF STRUCTURE: Industrial PROJECT DESCRIPTION: (2) New Boilers in existing boiler room building. INSPECTIONS REQUIRED I Inspections 1120 Foundation 1150 Slab/Flatwork Foundation: After forms are erected but prior to concrete placement. Slab: To be made after an ins lab building service equipment, conduit piping and other equipment items are in place but prior to concrete. Ufer Electrical Ground: Install ground rod at footing and call for inspection in conjunction with footing and/or foundation inspection. 1160 UFER Ground 1800 Emergency Egress Lighting 1829 Special Inspection 1999 Final Building Final Building: After all required inspections have been requested and approved and the building is complete. 2115 Exhaust Duct 2170 Fuel Burning Appliance 2300 Rough Mechanical 2310 Rough Gas 2995 Final Gas Rough Mechanical: P!ior to Cover Rough Gas: After line is installed and required testing and capped if not attached to an appliance. Final Gas: When all gas work is complete, Final Mechanical: When all mechanical work is complete. Rough Plumbing: Prior to cover and including required testing. Final Plumbing: When all plumbing work is complete. 2999 Final Mechanical 3500 Rough Piumbing 3999 Final Plumbing 4500 Rough Electrical 4999 Final Electrical Rough Electric: Prior to Cover Final Electric: When all electrical work is complete. Epoxy Anchors Hold Downs Installed Springfield Building Permit 1/5/2011 9:14:25AM Page 4 of 5 . . Sf~IHG FIE~ :' .'-' .~ ~. >;L~ OREGON CITY OF SPRINGFIELD 225 Fifth St Springfield,OR 97477 Phone: 541.726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 www.ci.springfield.or.us Building I Commercial Permit PERMIT NO: 811-SPR2010-00914 IVR Number: 811169573105 perm itcenter@ci.springfield.or.us PROJECT STATUS: STATUS DATE: Issued 01/05/2011 ISSUED: APPLIED: 01/05/2011 12/16/2010 EXPIRES: VALUE: 07/04/2011 $2,000.00 SITE ADDRESS: 470 S 2ND ST, Springfield, OR 97477-5308 ASSESOR'S PARCEL NO: 1703353300500 SCOPE: Mechanical Only WORK INVOLVED: New TYPE OF STRUCTURE: Industrial PROJECT DESCRIPTION: (2) New Boilers in existing boiler room building. 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 of the State or Oregon pertaining to the work described herein, and that NO OCCUPANCY 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. 1 further agree to ensure that all required inspections are requested at the proper time, that each address is readable from the street, that the permit card is located at the front of the property, and the approved set of plans will remain on the site at all times during con~t) 1hJ , Owner or Contractor Signature /~/( Date / Springfield Building Permit 1/5/2011. 9:14:25AM Page 5 of 5 ,'\ ; i'r'" / #/ ~~ttal'-~"Je- ,Ji City ofSprinsflcld Community ServIees Di'Yi.ion 22S Fifth S1reel SprjDfJfi~Id, OR 9'4'17 Telephone: ($41) 726-3759 Fax: (541) 726-3689 .A.. ,'f': .A~ lluildin&PomriI# 11"/'1 'llIla ~1M4l.A.}r;.MiI: .8_0.1_ &a.J-.... ~ ......d..N'r" Project TItle '17~ -:;., S;Ul!>/"l> SoT Si'l!J~""",,,,,r.... on ProJocl Address . SpodallupeoUo. ..d TealiD& To appIiclats ofprojedl reqalriallPccW idspcctioD crtestbt:: &I per SKtJof\.1704 Clf'tb& Orqon Strudaral SpecWty Code. Plcue.mew the IbfonwiQ.l bGlow. Whm )'OlIhaw . ........ oo<tnowIoda< on""""-,,, of'" _ by...... bolow.... ......'bJd."" 10 Ihc ciI,. B_A.PEllMITC,," lIE - 11oo_or........_-. .....odrioOofthc.....,..roloProjcot&a;-'" Antltoot.sIlIIl -Icto,"tn.... ....."..Ibe C1tyrmrniew.-u:l~w.I1bletxmOl)~onbolbtbe.fiontaDdbM;k. . . Tho........."""" """-, ..........'_ obIIl....""""""""...follo\rioB_....._.. s"'""" lupcoll..adlorT"""r. I. ~b..IlIibIeforprQper~for1hcJmpedionorTQ:liniof~tincd. 2. T....._..illaII"".IJ'IX'OpriaIo............_.....,,_............._................., . CqKesofaD ~fe9OfUMII i:ll!lpecticmsan:4l1ba&eD~IOIboCiJ)' by dill Tostil:lJApcy. 3. Special'~ Agcm:y is 10 Il1bmk namea aJUl qaliflcaJofts o(on1itc SpeciIIlliispodmslo the Clty10r ~ .. SpcciaI_....I............. _" 1bc I>oWIiq olllolot ofoll Iupccticn....-. s. ec_R.........bk........w CiI,'l'P"""'."", fbr_OOIlII.......... or..................1bslmoybo..1ooI. BUOU A CIIl11JI1CATB OF 0CCtJPAN'C\' WILt. BE JBSUJID; 'Ib& SpeclU 1nIpeclion A!coct1 m.n ..m.it1Dtbo BuildiDJ Offlaial. a mrtIlmem:thatalJ IIems requirinrl ...--'-IoIIl11ao1..."J'Orlod............""'of...............""""o<.ln_......._.t........................""""-... provIlloaa. 'nme!tans fttll:tIeSlt.d 1lDdIor~ sfttIlbcnotcdm. mclWcmcbL ThcRpOrti'to~ A11:Iml&tcd101tio CitypliorloalCqllC:ltformw inIpectioftJ. .A.CICNOWLEDG.EMl:N'l'S r' ~K"'''UIt ~1U:'1 tlIl>!JdII$ "Pi\V1~ ~1'1!.l"'U Ow=N.... (Prbrted) OwnuSi ~::r~~~i . l Testing LabonlOly Nsm, (Printed) ~dtiog La ~'\<"w\",\.-.e. Oeo,CooInu:Jo,FUm .(Prilllcd) '1J. :t'f'O~e.s~jO~1 ~Niw. I . (\'riD! Sign. :..----- Boildhta Official Sipiwe -..'-i';"~ ~ . ,." . . SPECIALlNSPEcnON AND TJ:STING SCHEDULE Rt:Wbrced GmiIB DdMottar. eona.oc Gun" am. Menor Gk.Un:N'G, EXCAVA~,.um PILL Aotcptmcc bill . PSP _ ~I"fi"'"", Plll__.......... SoiID=ky S'rRtJC'I'UI{ALSTBILJWEUJING: .....1. Illd ....(1iftI(l'CDlc_ boIow) """'---(mIJlcort) _ Wold.......... _"""'_FIoId ~-"-"""'-'''' 1IlshSUq1h00,,",*-5!loI>_Y"" Am _N _x ---y A490 _N -.J< _F Iddol dock "ddJo& .......... ~_"'dbIJinopccI;o. 1labdbnUs"" mIJl =1_ MttaIItAd-........... . eo...... louutwoldlni.......... Moment ralJtia& Ittd inlnes SlROCI'UllAL WOOD: . --~inspoaiOD --....... lmqIcdiollorOlu-bro.r.b.._TlCpsi Ib:spcdimIDftnwjabtfib.. SlIIIlpIllmdtr.;l:'"VIf -. fabricukm~iuaaflfa!:l'~ MASONRY . ~inlpocQQA""",,_ _flA_f, ~""""","_(_...I1s,,QJlpri>ma) ~""(monar.........., ""'.......) _~.r_"",_ ~,_,_aodrcl_f1<d..mr..... TC!lofMix ~T'" Mix . W R""""._ CoatiaaatIs B.sdI Plaat em' "'" " ... ""'" T.... _Con<nIr. pjlel l'ost-Tcm J'r&.1e.ns T.." IWmbn:In Tem 1'er&dODTcst ... p- c.._ ~. CoDcro1<._ lftItaJlatIon aD. Cast~ ~TMtI SMOKE COHTllOL: -Lookqe ...... _ConIlolV_1ioa ROOFING, l\A.b;d.,.imh11ati.cmIR..VIl1~ === Tell: ItrfJIsIItSnS PIREPRoorING: _P_jNpccIioA -""""".... 'l1lkb.cu "'" -I._~ ADDmONALlNSIWcnoNS,OTBBRTEST.IJr.JNSPECI1.0NS: lon:D~by: Dm ~~:':":;'~;:::dl:'1~::n:~~ ,e;;~I\:~~i:~r;;:.:~ '/~1i. ~:~~":,!;.~~:;,~~~;~::!.~';;~~:, ."..".,:; .....1I...f,. S='!I. 'PI.OVIDE S1'RENG'J'H UlRD IIV AltClll1'ECTOR. ENGIN&BR OJl. CONl'JL\.cr DOCUMENTI..OCAl1ON Oll'VAJ,.UU 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. ~;:t:':i~':;)':,,:cMi:G6R~:'!.Qf,~CpN~TRlJq'fIQN'~t\;;~~:,(~,',j \" ~, o Residential 0 Government KI Commercial 'i~0i"">~-""-' --"'~",' -'-,"'-' "'-_"~- ',.. "'-,' ,,'H_ "~.' ...'_.....- ,'~ l't'.... """ '_";.~o" ''C''''- ,-"~ "'-'-"--'H-'''';1'''Il:''-''~ ~,,&!jf,!i":JO~\l:,l)IWE'~IN ~9Fl,1VI.~,!19NRI!,NI)1\1;9.<::l!,ljIQN1';\t"i,'ii~i:; Job site address: '-1'7. S~~ ~ r G' ZIP: '!1't1? Reference: ,013 51'1 Taxlot: ooSOO ...... DESCRIPTioffoF' WQRi(' .'. (>.>lil+- Sell I t-' ~'M~11 .:>t.A irtf~~t~:~~~~,~~Rt~~~~BmX:,~jQ)N.~~-BW~~~~~~%t;~~ Mechanical Permit Application -- '" ~ '"', <<'1'"+..,,--., .""><,,,. l!~\,;;~ f~'\~ ,., l" ~C:€,I~ltQF~SRRiNGFIELrii'<fREG0N;:'c'- ...~;:i<.=""",~l~ -""..,~ ^ '.''':rt''_,,,,',~,%-,,,,,, .,...,~ '"",,,,,,,- , ,~;:c. i1i*'=~_;h'1. :.};j~-.- 225 Fifth Street. Springfield, OR 97477 . PH(541)726-3753 . FAX(54])726'3689 tU--ll CJ\L.~ Signature: ~"",""j)j;~:"'.JC-ON' l'RAC';;O:Ri;jNStA;(I!fAtI0N~'r""'1:ff,.'; 'S";"~:"'!'i ~~cl;r~:~.,;(->+,,,., .".,;_,'. ,. __..lIL_.".,1:i-._. i. ;"',.L:,__",../_L,___._.,:.....~,<t,t.o;l,t"-~.:'.1jlt"~, E-mail: CCB license no.: Print name: Signature: J. 440-2545-) (1 ]/08/COM) ;~~'I~:P~!ARI-'~~fr~~'~:B~~EX.!~~~~ Permit no.: 510,- CjIL{ Date: /2- Ih () ',' '<" ..,~ '. :,,',;'- i','" 'FEE SCHEDUL.E "\-;' " " . " .. .' ,-< .>.;;".,",.~"Ji: ':.,_...i ',,;\,';",..' ;""" ",." ),',;:", ,'r,'.:'Ii. '.',,' i;~, -'-'.. '. ..1. ~ C st",,-, , .,Iotal, ~Resltlentlal!iifi,;t1"il["\ii""""::i",""~,'" Qty;'Ii'W' .R""',, ~,<;:;":,"'-..:<"~''I,,~,',,t.',,'-;''I'...:.,..'"''!~~~;o1'{:l~_ ,_~,._r,,:";,;'::o..~;~;li,()i0':~r, .'4 ,k".'~ j- '.:.i€ea:;tr..;;,; ~~:cost,i%.'; First AODliance I $79.00 $ urnace/burner including ducts and vents Up to ] OOk 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 Upto ] 0,000 CFM I I $11.00 I $ Over ]0,000 CFM I $20.00 I $ Comnressor/absorntion system/heat numn Up to 3 hp/l OOk BTU $17.00 $ Upto ] 5 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 Domestic incinerator I $20.00 I $ ~ ~ -'.".' "'h" :",;.;c', Enter total valuation of mechanical system -f!p- r:; "/6 ( ~ and installation costs $ -2..Dt!)~ ~ 7 Enter fee based on valuation of mechanical system, etc. $,)!J v [r~j!~~!~v.iey]rf~~!~~~m~f' itiiii~ ij({Cost~' ~~.Total\~j',' ~~~';'=~-:;tf"'~ , :;~',;,,:'i'1 ,.~,ea.. :..." , ,_::?cost;f',~:i Reinspection $58.00 $ Specially requested inspections (per hr.) $58,00 $ Regulated equipment (unclassed) $13,00 $ Each additional inspection: (I) $58.00 $ ;::-~'f$P':f~~it1t";if:,j~r"~""M'<;~' '=',"...!(i-'~,._..'fl:~~~tI~~~~ (:s;:'ii"A!.;y.=-I'''-',~~,~~/;1!:;f,iZ" Jl~.e_RL;:I.C,~N:r:~il!JS,E}h::"\!',;~.. ~,~~t~"'~;l}f.~), (A) Enter subtotal of above fees (or enter set (3/50:1- minimum fee of $ 79.00) (B) Investigative fee (equal to [A]) $ (e) Enter 12% surcharge (.12 x [A+B]) $ (D) Seismic fee, 1%(.0] x [A]) $ (E) Technology Fee (5% of [A]) $ TOTAL fees and surcharges (A through E): $ <; --- . . SPIW'IG.,_.F..IE. ~~ ~\.L . ?i(~ ... "",v<. OREGON TRANSACTION RECEIPT CITY OF SPRINGFIELD 225 Fifth 51 Springfield,OR 97477 541-726-3753 www.ci.springfield.or.us 811-5PR2010-00914 470 5 2ND 5T permitcenter@ci.springfield.or.us l\:;.',P;A VMEN1::tXPt;::. ~;i"pA VbRr~;,;;'c.: CASHIER,,"CARP."T.R" Check HEX ION SPECIALTY CHEMICALS INC RECEIPT NO, 2011000020 RECORD NO, 811-SPR2010-00914 DATE: 01/05/2011 t6ESCRTe.TION.jr:";;i"-4"';::i?"7~\1.~' ......;-. ;',:.'T?1.,\,{-,,!;,;,'~'AcCblJN:t:-cobEi!::::' \~'T:&'\;";'Al\iiblJNtDlJE1. '.':- '-'~ ;'J Backflow preventer 224-00000-425603_____. 19.00 .~~~nce.5'~ Minimum Plumbing~!!.,:,~_~.____ ____ _-E~~56~_____.__.,,__~9.0~___._ _~i~~_~.e~!!!_ee ___.,.____ 224-00000~~??_~2~_____.______ __ 58.00,,__ __Mec~anical Permit fee (based on value of work) 224-00000-425604 3,150.75 ,____ State of Oregon Surcha~~-,,- (12% of."pplicable fees) 821-00000-215004 _ 392~ _..__ Structural Plan Review Fee Commercial 224-00000-425602 37.70 Technology fee (5% of permit total) 100-00000-425605 163.34 TOTAL DUE: 3,859.80 - .C;QIVIMi;NI$"''t;..i;.,~~Y-~:;1.-..:AMOUNTPAID.-_, ,oS; I check # 392181 $3,218.61 Credit Card Thomas Curtis Auth 074370 $641.19 074370 __,_~_._w_~ _._________. TOTAL PAID: $3,859.80