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HomeMy WebLinkAboutPermit Mechanical 2004-7-16 (2) . .- Status: Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line l..l i t VI' ;,rK11~u"1.r..LU Bu_ing/Combination Permit PERMIT NO: COM2004-00846 ISSUED: 07/16/2004 APPLIED: 07/12/2004 EXPIRES: 01/16/2005 VALUE: SITE ADDRESS: 3600 FRANKLIN BLVD ASSESSOR'S PARCEL NO,: 1703343101000 Eugene TYPE OF WORK: Mechanical Only TYPE OF USE: Alteration Commercial PROJECT DESCRIPTION: Replace electric HV AC with gas units. Owner: MYRMO & SONS INC Address: PO BOX 3215 EUGENE OR 97403 Contractor Type Mechanical I CONTRACTOR INFORMATION I Contractor HARVEY & PRICE CO Phone 541-746-1621 # of Stories: Height of Structure Type of Heat: wa~er ype: Ra I)',\?e: .~~ y~th: {.~p':~1illled Building: -~ .~'\ /",<, 1 ~...... . ~-.. -- " J<J>EWLot!I1ENT INFORMATION I ,,<<" '\~,.! ~~ ,0 REQUIRED PARKING .'>..~ ~ o..~ .\o~ ,~~~_ S..... ~'<; ~" Overlay Dist: rt>'" VJ"" ,0' ~qtal: ~<i,. #- ~ ~~ ~ {;l ~~' # Street Trees Rqd: ~ (f~ c,*" ~a\ll'icapped: ~'\~ ~<<,,~ ~<<; ~ ~ f<,~ Paved Drive Rqd: ~...q; O...q; ,q0 O:l~<l,;:,,$O~pact: ~ ,'is? . ">.\:)~ _''.J<<; ~ ~ % of Lot Coverage: ,'I> .;s.0 :"'0C,0~ 0....:s o~~ ~ '\,. ~..... ~- ~,. O~;\....:s 'S' ff' ~O ~~~ ~~A4~~4 ',,:~ . I PUBLIC IMPROVE~t~'1~~."~~~o~,'':<>~~~~~<J~~. ,- I ~~ ~,.i">.<,v ~0 .~ ~ ^<v~. ~~p (;0 ~ 53 ~mtll?~.C:l:'l; ~. ~~.o~ !:l<;;) 0 \'~.. tjp ~ ~o, c.~ b'lJ ",,'1>~ ~nmu!O!}tDrains: "i. ,~~qj 0:>" v U',,_ ~O~O'?' 4,0 .;s.0 ~.;s.\{> '\~ ",O:l<;;)' ~~o., \,0 ~q; <;;)'"' v~ ~q; (;0 _,,f' , I Valuation DescriDtion I # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: Front yard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: Notes: Description Type of Construction License 77 Expiration Date 10/3112004 BUILDING INFORMATION I B Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: VN n/a $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Total Value of Project "___ 1 _~" . \...11 r VI' ~rKl1'1uI'U..LU BtpdinglCombination Permit PERMIT NO: COM2004-00846 ISSUED: 07/16/2004 APPLIED: 07/12/2004 EXPIRES: 01/16/2005 VALUE:, Status: Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line I Fees Paid I Fee Description -Mechanical Issuance Fcc- + 10% Administrative Fee + 7% State Surcharge Furnace - more than 100,000 Gas Outlets 1-4 Minimum/Adjustment Mechanical Amount Paid Date Paid Receipt Number $10.00 $4.50 $3.15 $30.00 $4,00 $11,00 7/12/04 7/12/04 7/12/04 7/12/04 7/12/04 7/12/04 2200400000000000909 2200400000000000909 2200400000000000909 2200400000000000909 2200400000000000909 2200400000000000909 Total Amount Paid $62.65 I Plan Reviews I SUB Review 07/1212004 07/1612004 APP JF hvac only. To Request an inspection call the 24 hour recording at 726-3769. All inspection requested before 7:00 a.m. will be made the same working day, inspections requested after 7:00 a.m. will be made the following work day. I Reouil,-ed Insnections I 11111.1. Rough Mechanical: Prior to Cover Final Mechanical: When all mechanical work is complete. Rough Gas: After line is installed and required testing and capped if not attached to an appliance. Final Gas: When all gas work is complete. SUB Mechanical: Following City Rough Mechanical inspection approval and prior to any cover. By'signature, I state and agree, that I have carefully examined the completed application and do hereby certify that all information hereon is true and correct, and I further certify that any and all work performed shall be done in accordance with the Ordinances of the City of Springfield and the Laws of the State of Oregon pertaining to the work described herein, and that NO OCCUPANCY will be made of any structure without permission of the Community Services Division, Building Safety. I further certify that only contractors and employees who are in compliance with ORS 701.005 will be used on this project. I further,agree to ensure that all required inspections are requested at the proper time, that each address is readable from the street, that the permit card is located at the front of the property, and the approved set of plans will remain on the site at all tim uring constljJJCtiofi\ . ~ .1. U~~t/C- / 'jC {/~ t-o < ,_ I ~- 0'-1- ~ Owner or Contractors Signature Date n~__.., _".., I-rar- UI U, 11;'~a narve~ ana rrlce ~ompan~ l::>"j J '..b-tj1c::::t p.l . cSJ . HARVEY & PRICE CO. Fax Transmittal Sheet CCB #77 Date: , ~:;~4 d:;'~';:'ro." r7;L/?___<:-n_ ~$ Firm: Atto: Phone: Fax: ?;;...;;; ,?jf:'?h From:~,,/)oI&~ , Re: ~:_A ~_, , / #~ .-...~ k~~ 31060 f'~~<"l-l N / r Number to call to confirm receipt: 541-746-1621 Sender's fax number: 541-746-8729 or 541-741-7646 for Brian Kuhoheno Message: E"-// ..<:'n~ 4?,&';;"'~_ ~<" - , - Col\<\ 'Z..oc4-- 00 '5' ~ ---"<> .~~uz Fo S'T.'S-\'L I p. 0, ~ 1910 ~, o;e 97440 ~,(5411 746-1621 7... (541) 746-U29 "'66@"....'I1Y~.-. <e4 ()()077 1.I~r UI U~ 11;~~a narve~ ana ~rlce Lompan~ l::J11 J -I"'b-tl-/c~ Form 4b #/'1 riM f) ~ <;;'1$ Project Name:. Page: ( I COMPLEX HVAC SYSTEMS 1. Simple or Complex System (Sections 1313.2 & 1313.si Note: This lorm Is required lor complex systems only. If your plans qualify as a slmple system as defined by the code. you can skip this form. 2. Simultaneous Beating and CoollDg (Section 1313.3.3.11 o No Cooling- The building plans end speciflC8tions can lor a heating-only system. d' Complies. Temperature and humidity controls are capable 01 operattng In sequence the supply r of cooling aOO healing energy to the zone as .res1uired by the code, Controls for this purpose are ti detalled In the plans and specllicotions on: Mlf!:.P., ~~r Excep. ODS 0 Exception_ The building or part 01 the building Qualifies for an exception lrom the code. The Discussion of applicabIB code excepllon Is Section 1313,3,3.1, Exception:_ ' Portions of \he building thaI qualifying --". qualify: tions on page 4-20. 3. Humidity Controls (Section 1313.3.3.2) . . ;;r No Moisture Added to BuildIng. The building plans do not call for a means 10 add moisture 10 /" malntaln specllic humidity IBVBls, . o Complies. All new humidily control systems are equipped with a humidistat as required by code. Air Transport Energy See TabiD 13-1. page 4-24. (", maximum horss- power alJowed. 4 Air Transport Energy (Section 1313.3.4.2 & Table 13.LI ;;l Complies. The energy demaod 01 all HVAC Ian systems meets code requirements, Complete I" the form below. I.J Exception. The applicable code exception is SectIon 1313,3.4,2. Exception:_, Porllons at tho. ~ ~~ I ~ . System Constant Design Motor Allowed Where noted In 10 Oescrtptlon Volume Airflow (elm) HP HP plans/specs I t:'t4-1 qPf..fb()l7. c,/ *",e.. 3,'7 t:n~z 4(#-I6()12- e.'/ I , C/oc&- 3,7 building thel qualify: 5. Motor Efficiency (Section 1313.3.5 & Table 13-M) o Not Regulated. There are no NEMA Dest9n A & B squlll'lll cage. T-frame induCllon. pennanenUy wired polyphase motolS of ono horsepower or more which serve buin-up HVAC systems (regu. ri latad motors), );, Complies. The efficiency of ell regulated molars meets code requirements. Exceptions 0 Exception. The applicable code excepUon is Section 1313.3.4,2. Exception:_ ,Portions 01 the buUdlng thet qualify: 0iswssI0n or quaBIyIng - tionsMpDg.4-22. J Variable Speed Drives (Section 1313.3.5.1) Not Regulated. The building plans and speclfica~ons do not call lor tan and pump motors 25 horsepower end greater that serve varlable.flow air or Uquld systems. o Complies. All fan and pump motors 25 hp and grealer which serve variable-flow air or liquid systems are controlled by a venable-speed drive. (10.00) Forms & Wor1<sheels p.i::: - 4-3 nar Uf U~ 11;~Oa narve~ ana ~rlce ~ompan~ l041 J .,..t:i-tf./c~ p.;:! . . Page: Z. Fonn 4a (con!.) SYSTEMS - GENERAL Project Name: 7. Off-hour Controls - HVAC Systems (Section 1313.1.3.31 Jii COmpiles. An new HVAC systems ere capable of eutomatlc setback or shutdown during periods of non-use or alternate use of the space served by the system, o Exception. Equipment has fun load heating demands of 2 WI (6,826 Bfulhr) or less and is control1ed by a reedlly accessible manual off-hour control. 8. Off-hour Controls - Supply BDd Exbaust CrJ,,:_--,g 11313.1.3.3) " COmpiles. Plans require that outdoor eir supply end exhaust systems have a means of auto- matic (either ...',:_.:~_j or-gravity damper) lI01ume shutoff or reduction during periods of non-use or alternate use of the space served by the system. o Exception. The bUilding qualifies tor an excepllon to the requirement tor automallc: shutoff or reduction, The appficable code exception Is Section 1313.1.3.3. Exc:eption _' ~ Heat PaDip Controls ISection 1313.1.3.4) ya No Heat Pump. The plans/specs do not c:aillor a new heat pump, o COmplies. AD new heat pumps equipped with suppl_.,,~,,;"1)' heaters are controlled as required In Section 1313.1.3,4. ~ ',,01 quaIllinp ."""1>' liansonpago4-lB . 10. Equipment Performance (Section 1313.1.41 o No New HVAC Equipment. The building plans do not call lor new elecIrlcal HVAC equipment, combustion heating equipment or heat-operated cooling equipment. J4 Compiles. AD new HVAc equipment haS eflIclencles not less than those (BQulred l1Y \he code. The following equipment efficiency worlalheels are atlaOhed: .fb<J...", f .d...A... . 11. Duct Insulation (Section 1313.2.281 1313.3.21 o No Duels. The building plans and specIti..".JL..~ do not c:ail1or new HVAC duds or plenums, o Simple System: Compiles. The plans and ~~~..;;:...;.;;.., ~ c:aillor a Simple System. and all exterior supplylretum air-handling ducIs end plenums and en outside air duelS are Insulated as required by SectIon 1313.2.2. ,rI Complex System: Complies. The building planslspecs caD lor a Complex System, and all air- T hanclling duelS aml plenums are Insulated as required by See, 1313,3.2. , ~. Piping Inm1at101l (Section 13141 ~ No New Piping. The buUding plans end specifications do not cell lor new piping serving a .heating or cOoling system or part 01 a ctraJlellng service water heating system.. o Compiles. AD new piping servtng a healing or coo\Ing system or part of a clrculating service waterheallng system compiles with the reqt~..., ,..:.>oltheCode, SecI10n 1314.1. o Ex...~::.. ~ New piping quaJilIes for !he IolIowlng ~._~~~"": SectIon 1314, Exception _ . Exceptions Exceptions Dioc<,.,.., 01 ~- _on_4-'8 9. Service Water BeatiDg (Section 1315) 14 No New Water Heating. The building plans and specifications do not call lor new wale. heaters. hot water storage tanks. service hot water distribution systems. swimming pools or spas. o Complies. AD new water heaters, hot water storage tanks, serVice hot water distrlbUlion sys- tems. swimming pools or spas comply with \he requIrements 01 the Code, o Exception. The appIlcabIe code exception Is Section . Exception _ ' Portions 01 \he building that qualify' 4-2 Forms & WOlkBhests ('OIDO) nc:H- U I u-r .1.1; -ro:JcI Worksheet 4a narve~ ana rrlce ~ompan~ . project Name: l;;l"tJJ ("tC-C(C::J . p.., Page: .5, Equipment Cooling Proposed Proposed Seasonal or Part 0i3cu..... of Equip. Model Designation Capacity Steady Stata Load EffICiency Ref. equipmonI ratings /0 (BtuIh) Efficiency (EER) Une end equipment (SEER or /PL V) de/inifions on pago 4-,g I ##.16 ~/2- / 2-0 p~o //,()~ ? z... qjH-/6 t112-- / ~o PI?O /I,t>() ? Required Document(l- tion Code Required Efficiencies __01 eqvIpnionl oII/CIencles .... f8f0tm8_ from Ih8cod8, r_13-G 0...1;) 1:' r-: O..H FORMS OCT 2000 4-4 Indicate source of Information ----ARI Unitary Directory, Section AC. page: ARI Applied Products Directory. Section ULE, page: Product data (Attach data furnIshed by the equipment supplier. I,e.. "cut sheetsj I 1/ or e i iea e se ed Dmvided Equipment Type Single Package without a heating section or witfj electric resistance heat Sp/H Systam withOut a heetlnl1 section or wItfj electric resistance heat Single Package with 0 heating section other than electric resistance heat Sp'/H SYStem with a fleeting section other than electric resistanca heat , Condensing Unit Only Cooling Capacity (Btulh) Equal to or B greater than ut less than o 65,000 135,000 240,000 760.000 o 65,000 135.000 240.000 760,000 o 65.000 135,000 240.000 760,000 o 65,000 135,000 240.000 760.000 135,000 65,000 135.000 240,000 760,000 65.000 135,000 240,000 760,000 65,000 135,000 240,000 760,000 65,000 135,000 240,000 760,000 Forms & Worlcsheets Minimum Rating Seasonal or Part Load 9.7 SEER 10,61PLV 9,91PLV 9.7IPLV 9.4IPLV 10,0 SEER 10.61PLV 9.9IPLV 9,7/PLV 9.4IPLV Steady State na 10.3 EER 9,7 EER 9,5 EER 9.2 EER na 10.3 EER 9.7EER 9.5 EER 9.2 EER na 10,1 EER 9.5 EER 9,3 EER 9,0 EER ne 10.1 EER Il,SEER 9.3 EER 9,0 EER 10.1 EER Ref. Uno (1) (2) 9,7 SEER 10.4 IPLV 9.7IPLV 9,5/PLV 9.2IPLV 10.0 SEER 10.4IPLV 9.7IPLV 9,51PLV 9.2/PLV l'.2/PLV (3) (4) (5) .1 (10100) nar- Uf U"T J.J.;;"TOa nc:l"-'Vlt!'~ ClInOl r-rlce l..Omfl'an~ l:)...lJ ARI* capacity lings UNIT MOMIIlAL STMIlARD c:ootJNG aHJ roNS CFU ~t . EJRlO4 3 12C1O 38.000 - . "so 46,000 D/EJFOO6 5 1750 61.000 Il/EIAlO7 . 2UI. 74.000 MIRlO8 7.5 3000 80,000 M;JFl109 8.5 3000 102.000 llIEJFO.2 I. 3200 120.000 POI' 125 4300 139.000 "'4 125 4300 139.000 LEGEND 8cIs Somd LIN8b(1 bel = 10 dedbeb} EER Enerw E/fIdenCy ReIio IPUI - "0 ...... Part.l..OIIlId Value SEER SeesonaI Enerw E1fidency Rallo "'_' ...' ';..il. ..ng&r.. '~l ....:... 1nsGtuto. tAclPIles orIy to inti; _ capodIy 0I6S,OOO IlIlA1 '" leSs. "ThoIPl.lllsnol~to;.,.. . ............ NOlel: ,. _In ....'.., .. _ AlII _ 2'0/2<0 (004-0'2 ....) '" 360 (01......).... 270 (004-014 unIIs~ 10TAL IlW 3.21 4.25 S.SS ..70 8.18 9,44 10.91 14.04 14.04 2. SOUND RA11NQ ~\ 11.20 7.6 11.05 7.6 11.00 8.0 11.00 8.0 11.00 8.2 ".6 10.80 8..2 10.9 11.00 8,4 11.4 8.5 8.e SI.O 9.5 1.6 9A Ratings are net....... ..1lB<ting Ihe _ of c:l1allaIIng Ian ...... Rallngs ant baaod on: ~~.~~lndoorenterfng.elJlempeta!ureand95F PLY Standard: sO F db" ff1 F wb /Moor lINerinO-air tarnperaSurn and DO F db_en!orinll-Bir""""""", ' . SEERt EER 13.. ,3.. 1S.0 . SIuC 004.012 Only HEAllNG CAPAw,u:.3 AND EfFIciENCIES 208/2StH 060 - SINGlE STAGE GI\S HEAT OUTPUT CAMClTY . UNIT 4IIKI BI04 RI04 -- EOOS RlOS IlOO6 EOO6 RlO6 INPUT """""'" 1"~ _SIne 72.DfKJ 1\5,000 72.DfKJ 116.000 150.000 72.DOO 115.000 ,so.ooo 1&1 SIa\1O 61)040' 92.000 ...... 93.'50 '2OJlOO 59.... 83.150 '20.000 -- 'I1!MPERA1VRE R1SEI"Fl t5-45 ~ 15-45 ~ ....,. 15-45 ~ ~ ~ 208/2StHo6O - SINGlE S'mGE GAS HEAT - LOW NO. OUTPUT CAfIlCm' UNIT 48lIJ - ..... l.nos - -- LOO6 - ..... INPUT CAAU:ITY '''~ _Sloae 60.000 .lum 60,000 80:000 .20.000 60.000 90,000 '20.000 .&1_ ..s,ciioi 7..1100 48.ClOO ~ooo 98.000 4i.iiiiO 12JlOO 011.000 2nd __ 1BIPERA1VRE RlSEI"Fl ...... - ...... ..... 40-70 ...... 30-80 40-70 . UNIT ...... - ..... . LIIll!l - NII05 ..... IlOO6 ..... INPUT CAAlClTY 208/2S0/460-S060 - SINGlE S'mGE GAS HEAT - LOW NOx ....- OIITPIIT CAI'ACITY 1"_ 60.000 90.000 ",0lI0 90.000 '20.000 6O,OlIO 90.000 120.f'?9 1..!'!!l!" ....000 7?JlOIl .a'iJOO 72.000 98(100 ....000 72,000 ~ .... ...... TEIIPERA1URE RISE('FJ ...... - a\.!;o ..... .0-70 ...... :'IH;O ~~ l"'b-tlli::'::J p." ~ IPLV e S-.14 Only EFf'CIENCY AFUEll"1 _Slatell"' ..... 82 IlO'll. 80 .... 82 81% 81 .... SO ..... 82 81% 81 ..... 80 EFf1CIENCY AFUEll"1 -. Slate ""I ..... eo 80% eo 80% IKl 80% eo 80% eo 80% 80 80... 80 80% 80 EmCIEHCY ARlEI"" ""'" "'1'"' '"'" ..... 110% 8<'% 80% ~ __C,.I 'eo IKl eo eo eo 80 80 80 117 UP OfficeJet . . Fax Log Report Personal Printer/Fax/Copier Jul-12-04 01:46 PM ll!Im!ificatiog R!mll! ll!&!l! Ixm DlW; Iiml; ,Duratioll Diamostic 97443654 OK 05 Sent JuI-12 01:43P 00:03:23 002586030022 I,J.O " . . ' -, CiTY OF' SLJNGFIELD; OREdbN':~ ;';'-: : ,';. '" : , ~ . I _.', " - . . ft (0'\\ ~ IC 100" c....? hl,.. \-'\1>< Z. I ":!oO l\ I ( - 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 b'Z.,\<>> City Job NumberCO~ '2.OD4- ~'DO~ Date 0 l - \ L -06,- o I & 2 Family Dwelling or Accessory 0 New Construction o Multi-Family ~ AdditionlAlterationIReplacement ~ CommerciallIndustrial 0 Tenant Improvement Job Address '3 ~<!>O PKlItN !CU~N BLvd., Lot Block Subdivision Project Name M.~If"""o ~ SON! Description ofWorkllocatior: on premises/special conditions RejJlftCE:. (,:{) VN iTS ~ r::.<lV i"N(j. (J Fi=/oce A.<eC';" B P~opertyOumer Name M'iI)~O 't ,rON~ Mailing Address iJ. 0, f3 /!) 1<- '3;J. I 5 City t::.U 6-SI/,; State Ol(!. Zip '7 7 ~ 3 Phone 7 ft7- 'T~'5 Fax ~.., 0 U'V Owner Representative '-'< (C "" v.lt /I{ 0 Phone 7 If-7 - 'I S" !: Fax . !J'C....r"~:>"",. "';'"l. '_ -.)." ..c....''':.~''''_.T~.j<;?~.''~ft.."1'< ..,.,:,::r.;r>l.A....'~~":'--.;',;.,,'""'-.~ ~ O \~p!,I'f~li~::iift)N:-.~t-~&~~':;f~~!A1~~~~;1::;;;~,~._.~;:~f~.rf~~if~~~~'0:.;J~ "... <<. "'-.- ."'. "'"-'",.,..,Y:/.....i>.,''' .'?':..',..,,'._r.. Name /m1!Vo/ ~ f'/~'CC '-<). Mailing Address tP_c)~ 130,1( ,1. Co City E:v H-,9I/' ~ State O/t. Zip '77 'i'fO Phone 7l'lD -{(j,~/ Fax 7~' - e-7~'1 , . " " o ,'A~chite~t/D~signej./Engin~e~ Name Address . "',J". State Zip City Contact Person Phone Fax o fr9.~lj~.;.<<a,~,n:(,9}H.: . ".'" Contractor's Name .' ., "-'.,.,,;,,( ...:: " J General Plumbing Mechanical Electrical o " :C'!.~me;;cialllnclUstriClI Projects Has site review application been submitted? o Ves 0 No 0 N/A If so, Name of Planner Journal Number SA,VI1 VOAA! E 1i/ftf.1I~ q/. ~'kt(cr ~/)If(\J'( 0.5 o o Demolition Other Bldg No, Suite No, Tax Maprrax Lot 1'( 0 ~ ~4--3 \ 0 lOeo 1 & 2 Family Dwelling SQFt x $/SQ Ft Value New Dwelling Area Garage/Carport Area Other Structure Area Total Value f:ki<~'t.,.i":'::,~~';".>>~..,?":.''''''''"~,-;;''",,,,,,'',,':~ " .-' . "<l'~ > , ,siJi/tnih'ct'i:i~lliridiJiHal/llfulti:F.izfuiiy';;~1.' :"i: I, '. ,:,;"., SQ Ft X $/SQ Ft = Value Existing Building Area New Building Area Total Value Existing New Occupancy Group(s) Const. Tvpe(s) Number of Stories , -",.". Expiration Date Phone # CCB# 77 w-:n-oy. 7 'for.. -(&,;,;./ o RcsiclentiClI Projects Heat Source: Primary Water Heater Range Do you require any of the following for this project? , Over.width or Second Driveway 0 Ves 0 No Temporary Power 0 Ves 0 No Notice: All contractors & subcontractors are required to be licensed with the Construction Contractors Board of the State of Oregon under provisions of ORS 70 I and may be reauired to be licensed in the iurisdiction where work is bein::!. oerformed. I:For Office Use Only . J I PLAN CHECK FEE I I RCPT# I DATE !01-(vOll.-1 BV 1.Jl'A\'" Secondary Energy Path APPLICATION BUILDING PERMIT /- Shared Drivc(T:)'8uildilll; Fonn..'ilIluilding reml;l Application IO.02.dOC' I . 225 Fifth Street Springfield, Oregon 97477 ;1 541-726-3759 Phone . a~,_.','_",""'_'!','" ~. .-: 1iiI.Y of Springfield Official Receipt .elopment Services Department Public Works Department RECEIPT #: 2200400000000000909 Date: 07/12/2004 9:17:50AM Job/Journal Number COM2004-00846 COM2004.00846 COM2004-00846 COM2004-00846 COM2004.00846 COM2004-00846 Description + 7% State Surcharge + 10% Administrative Fee Furnace - more than 100,000 Gas Outlets 1.4 Minimum/Adjustment Mechanical -Mechanical Issuance Fee- Payments: Type of Payment Paid By Item Total: l:heck Number Authorization Received By Batch Number Number How Received Amount Due 3,15 4.50 30.00 4,00 11.00 10,00 $62.65 Amount Paid Check HARVEY & PRlCE jmp 81217 In Person Payment Total: $62.65 $62.65 7/12/2004 Page I of I