The URL can be used to link to this page

Home My WebLink AboutPermit Mechanical 2011-4-29 Mechanical Permit Application 225 Fifth Street _ Springfield, OR 97477 _ PH(541)726-3753 - FAX(54I)726-3689 ~F: COcMWIO - 0 I Of ~ This permit is issued under OAR 918-440-0050. Permits expire if work is not started within) 80 days of issuance or if work is suspended for 180 days, .~; " 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 701.010. Signature: ~~tt;'ji,il~'ii~igQN:J;RACmQR~rli)l$TAt.~AfIPNlr',iil~,;,,';',ii' E-mail: .,,\}\O. '::I,) , \\\\"-; rr (7,/ ., ~\'(\ :'\ \,20: \I' C Ol ... '.''-' ()\~ S. . ,"'" y n,Cl 19nature.. _ r ,'. ~\ .\'. . ~..... ':j"::J", "c. 'Oi \,,-1\OI~''3-00?'~ 1'(\0'2>'<> ~l'f v;"\'(\e ~\)'~I'e J>.II€., t'Jo\eS Gel'\e~.:.$) \\;\\0 "16'0 ~~ \e\e?\~c,",\\O\l 1\\0" '01' \_(jv, CO,'. \\,. :i,,' ~O\I\ICt~"''2:()()'3-'l 0'$\'0.11' ~\O\0\\\I\'l ;~Al' . Of' "0" \\\ el'\'<;~' ,,0\1 ::,'2:7- II' 9()" \\;\e cOle", ClC)''-' ()(j '0.\\11'9; \0\ \'(\6 \'0 \_'0 C :0101 ,,\el 11"\\\ . (,10" Print name: 440-2545-J (II/08/COM) ..', .. ,7 -;. FEE SCHEDUl.E . . ~ij~~J#~r!,.!~'IA.~~;~,;;,~::~~~,:~{:;.~~y:\,;::;:M;~J~:ff~::J: ,~!r ;;\'::;~;~~~~4~;,,:, :,)'~tal. '"::y;cost'1,,,; First ADDliance $79.00 $ Furnace/burner including ducts and vents Up to 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 systernJ $58.00 $ absorption system Evaporated cooler $13.00 $ Ventfan 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 I $7.00 $ Additional outlets (each) $4.00 $ Air-handling units, including ducts Up to 10,000 CFM $11.00 $ Over 10.000 CFM I $20.00 $ Comoressor/absorption svstem/heat numo Up to 3 hp/l OOk BTU $17.00 $ Upto 15 hp/500k BTU $29.00 $ Up to 30 hpll,OOO BTU $43.00 $ Up to 50 hpll,750 BTU $57.00 $ Over 50 hpll,750 BTU $95.00 $ Incinerators Domestic incinerator I $20.00 $ ,~. ':::':".,':'" ""':"(("!;' '....:'r'., Enter total valuation of mechanical system and installation costs $ .J ~OC> Enter fee based on valuation of mechanical syst.em, etc. $ :~fNi)~F~'~~J~~ry,e,;2~:#^tt~~~:.f~i;f;~:!}H~i.~~~;\*~~:~,~t.~if?~I~..;~~~~~i~~ i'~ Total,..; c.!'-"icost}~;;;, Reinspection ..r: I \\'-l'$5ilIQ0 $ Specially requested inspections (PYr,I)r) II' "", $ " \<:,$58,00 \'"'"~' ..... \' . 11-\~'.:. Regula,e!!, ",quipment (~n~l~sed)., r \J~ <:0,$13.00 $ E~(~~addlfi~~~,.\;nsp~#~~~::( i) 'fi ~ ~ \ ,,( )\'li:\. $58.00 $ ...re~~~.",.~-ll:".<"f.'~m'1N.~....:""'..,.,,~:t;..~.,.l\~--(fi.",c..m.';.=~fit$'''i'''''.~'',.op~'t."~,:t:-':Y!; - i17ffe., \\. :;h',,,~~~';~;;: ;b!AeF?l1:Ie~NT:..,'=lJSE;p.,-;-.,>.po. ;_~-':1~\i:i-C<i~....w\t,/"1h--)i:"J:: """.~,c~ '".. 1,.". ,.,,~ ..""..........!:'..A... ..." ...... ".:.."..... .. .,~,'~~;';'"...ft..",;:~ ",""r,'_'_J,..,.",_",.l!:?l;k;.' (A) EhF6r~~btotaI'Of\lb\)ve~es'( or enter set '7 '7 minilrr~rp<re~,~f~.79~OO)t. ,- $ (B) Iny~~!igative'fee (equal to [A]) $ (C) Enter 12% surcharge (.12 x [A+B]) $ (D) Seismic .fee. 1%(,01 x [A]) $ (E) Technology Fee (5% of [A]) $ TOTAL fees and surcharges (A through E): $ 92 C( .> - .. CITY OF SPRINGFIELD Building I Commercial Permit PERMIT NO: 811-SPR2011-00717 IVR Number: 811122980831 www.cLspringfield.or.us PROJECT STATUS: STATUS DATE: Issued 04/29/2011 ISSUED: APPLIED: 04/29/2011 04/29/2011 225 Fifth St Springfield,OR 97477 Phone:.541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 permitcenter@cLspringfield,or.us EXPIRES: VALUE: 10/26/2011 $0.00 SITE ADDRESS: 3365 GAME FARM RD, Springfield, OR 97477 ASSES OR'S PARCEL NO: 1703220000904 SCOPE: Mechanical Only WORK INVOLVED: New TYPE OF STRUCTURE: Commercial Gas piping for cell site generator. REF: COM2010-01019 PROJECT DESCRIPTION: Phone Number: OWNER: ADDRESS: CITY OF SPRINGFIELD 225 N 5TH ST SPRINGFIELD OR 97477 CONTRACTOR INFORMATION I Contractor Type Mechanical Contractor Contractor Name DAN SAN ENTERPRISES INC Lie Type GGe # of Units: BUilDING INFORMATION I # of Stories: Height of Structure: Type of Heat: Water Type: Range Type: Hazmat: o # of Bedrooms: Sprinkled Building: Fire Alarms; Energy Path: Electrical Specialty Code Edition: Springfield Fire Code Edition: Mechanical Specialty Code Edition: Municipal I Development Code: Plumbing Specialty Code Edition: Residential Specialty Code Edition: Structural Specialty Code Edition: Lie No 57917 Lie Exp 07/15/2012 Phone 541-863-5040 Lot Size: Sq Ft 1 st Floor: Sq Ft2nd Floor: Sq Ft Basement: Sq Ft Garage: Sq Ft Carport: Sq Ft Other: 0 Occupancy Load: Site Information I Engineered Fill: Fill Volume: Flood Hazard Area: law requires youto land Hazardftrlf<lINTION: Orego; by the Oregon Utility Retaining WlI!lnow rules adopte Th se rules are set torth Soils RepO'ffl/ll1ldtllil:>n Center. 0 hOAR 952-00;- in OAR 952-001-001 ~ th:~~i~S o1the rules by 0090. You may obta\f1 Note: the telephone calling the center. (on Utility NotificatIOn number tor the. or;egBOO_332-2344). Center IS - NonCE:...,:. THIS PERMIT SHALL EXPIRE IF THE WORK AUTHORIZED UNDER THIS PERMIT IS NOT. COMMENCED OR IS ABANDONED FOR ANY 180 DAY PERIOD. . Springfield Building Permit 4/2912011 11 :20:24AM Page 1 of 3 . sr~~N~~L?ij .~~ "'Y.~",""" 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-SPR2011-00717 IVR Number: 811122980831 permitcenler@ci.springfield.or.us PROJECT STATUS: STATUS DATE: Issued 04/29/2011 ISSUED: APPLIED: 04/29/2011 04/29/2011 EXPIRES: VALUE: 10/26/2011 $0.00 SITE ADDRESS: 3365 GAME FARM RD, Springfield, OR 97477 ASSESOR'S PARCEL NO: 1703220000904 SCOPE: Mechanical Only WORK INVOLVED: New lYPE OF STRUCTURE: Commercial Gas pipin9 for cell site generator. REF: COM2010-01019 PROJECT DESCRIPTION: Frontyard Setback: Interior Setback: Sideyard Setback: Rearyard Setback: Solar Setback: DEVELOPMENT INFORMATION ~ 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 ~ Street Improvements: Storm Sewer: Storm Sewer Available: Speciallnstructon: Subdivision Accepted: Notes: Sidewalk Type: Downspout/Drains: Valuation Description ~ Description Tvpe of Construction Unit Amount Unit Tvoe Unit Cost Value FEES PAID ~ Descriotion State of Oregon Surcharge (12% of applicable fees) Mechanical Permit fee (based ~<:'0~-,:,alue of.~ork) Technology fee (5% of permit total) Total Amount Paid Amount Paid $9.48 $79.00 ___0______0 $3.95 $92.43 Date Paid 04/29/2011 04/29/2011 04/29/2011 Reciot # 2011000838 2011000838 2011000838 Springfield Building Permit 4f29/2011 11 :20:24AM Page 2 of 3 . SP:I~G..:E.L~ ~~ ~OREGON www.cLspringfie\d.or.us CITY OF SPRINGFIELD Building I Commercial Permit PERMIT NO: 811-SPR2011-00717 IVR Number: 811122980831 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 ISSUED: APPLIED: 04/29/2011 04/29/2011 EXPIRES: VALUE: 10/26/2011 $0.00 0412912011 SITE ADDRESS: 3365 GAME FARM RD, Springfield, OR 97477 ASSESOR'S PARCEL NO: 1703220000904 PROJECT DESCRIPTION: SCOPE: Mechanical Only WORK INYOL YED: New TYPE OF STRUCTURE: Commercial Gas piping for cell site generator. REF: COM2010-01019 Plan Review ~ Deoartment Permit Issuance Received Due Date ComDleted Result 04/29/2011 04/29/2011 04/29/2011 Issued Reviewer David Bowlsby Initial Review 04/29/2011 04/29/2011 04/29/2011 Over Ihe Counter David Bowlsby -" ''':' ',,' -i. - "".f t;\.". 1 ~, . INSPECTIONS REQUIRED ~ Inspections 2260 Gas Service Gas Service: After line is installed and line has been connected to a minimum of one appliance including required testing. Presure test done at this point. 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. 2310 Rough Gas 2995 Final Gas 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 ac~ordance 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. I further agree to ensure that aU 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 remam on the site at all times dUring W1~~ !/i/...J;JA 0'-(-,9.1-1/ Owner or Contractor Signature Date Springfield Building Permit 4/29/2011 11 :20:.24AM Page 3 of 3 . TRANSACTION RECEIPT CITY OF SPRINGFIELD 225'Fifth St Springfield,OR 97477 541.726-3753 www.ci.springfield.or.us 811-SPR2011-00717 3365 GAME FARM RD permitcenter@ci,springfield.or.us RECEIPT NO: 2011000838 RECORD NO: 811-SPR2011-00717 DATE: 04/29/2011 !tiEsCRIP..tfoN;:""T'f;~". "'";~t';: ,"'''';'''''~'t''~',:1~~"M,!~,Acc<>UN'(C<>DE'.iSj;''0':::2:l::''AMOUNI-DUE' ".i' I Mechanical Permit fee (based on value of work) 224-00000-425604 79.00 State of Ore90n Surcharge (12% of applicable fees) 821-00000-215004 9.48 Technology fee (5% of permit total) 100-00000-425605 _ ____ _____ 3.95 TOTAL DUE: 92.43 I'IR~YM~~T_21"Yf!.~~,-~,'-P~jQB~' 'cAsh)E~~DBowCs1iy,;2;;~2st~9M.M.~~isJ,g,!'7'~"~~'ir ",,_?'~MbUNT p4Iq:.:..~.:'L~' -. '::! Credit Card shields plumbing 92.43 095227 TOTAL PAID: 92.43