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Home My WebLink AboutPermit Mechanical 2014-4-3 • • SPRINGFIELD 225 Fifth St tit CITY OF SPRINGFIELD Springfield,OR 97477 Phone: 541-726-3753 -OREGON Building / Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2014-00722 www.springfield-or.gov permitcenter@springfield-or.gov • PROJECT STATUS: Issued ISSUED: 04/03/2014 EXPIRES: 09/30/2014 • STATUS DATE: 04/03/2014 APPLIED: 04/03/2014 SITE ADDRESS: 7169 B ST,Springfield,OR 97478 SCOPE: Mechanical Only ASSESOR'S PARCEL NO: 1702353103300 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: M-Heat pump and air handler,one for each duplex unit • OWNER: DUTSON CORY J Phone Number: ADDRESS: 7169 B ST SPRINGFIELD OR 97478 CONTRACTOR INFORMATION • Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone Mechanical Contractor OWNER CCB 000000 08/01/2025 Electrical Contractor OWNER CCB 000000 08/01/2025 INSPECTIONS REQUIRED C Inspections 2300 Rough Mechanical Rough Mechanical: Prior to Cover 2999 Final Mechanical Final Mechanical: When all mechanical work is complete. 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. 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 times during construction. SA-Pr �( Owner or Contractor Signature Date • ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility .TIr,E. • Notification Center. Those rules are set forth (HIS PERMIT SHALL EXPIRE IF THE WORK in OAR 952-001-0010 through OAR 952-001- 0090. You may obtain copies of the rules by AUTHORIZED UNDER THIS PERMIT IS NOT calling the center. (Note: the telephone COMMENCED OR IS ABANDONED FOR number for the Oregon Utility Notification ANY 180 DAY PERIOD. Center is 1-800-332-2344). • • • • Springfield Building Permit 4/3/2014 1:53:41PM Page 1 of 1 • Property Owner Statement Regarding Construction Responsibilities Oregon Law requires residential construction permit applicants who are not licensed with the Construction Contractors Board to sign the following statement before a building permit can be issued. (ORS 701.325 (2)) This statement is required for residential building, electrical, mechanical, and plumbing permits. Licensed architect and engineer applicants, exempt from licensing under ORS 701.010 (7), need not submit this statement. This statement will be filed with the permit. • Please check the appropriate box: I own, reside in, or will reside in the completed structure and my general contractor is: • Name CCB# Expiration Date I will inform my general contractor that all subcontractors who work on the structure must be licensed with the Construction Contractors Board. • or • I will be performing work on property I own, a residence that I reside in, or a residence that I will reside in. If I hire subcontractors, I will hire only subcontractors licensed with the Construction Contractors Board. If I change my mind and hire a general contractor, I will select a contractor who is licensed with the CCB and will immediately give the name of the contractor to the office issuing this Building Permit. I have read and understand the Information Notice to Homeowners About Construction Responsibilities, and I hereby certify that the information on this homeowner statement is true and accurate. Print Name ermit Applicant 3fPr7401/ y Signature dffermi Applican - Date Permit#: 9q — 7z/ f 72 2_ • Address: ?fie Si� mt c797r ` : - Y , • : - Issued by: Date:�L_ ae: 7 1( 859/ • This Copy for Permit Offices SPRINGFIELD - CITY OF SPRINGFIELD tt 225 Fifth St `y"; OREGON TRANSACTION RECEIPT Springfield,OR 97477 ,, 541-7263753 811-SPR2014-00722 www.springfield-or.gov 7169 B ST permitcenter @spnngfield-or.gov • RECEIPT NO: 2014000728 RECORD NO:811-SPR2014-00722 DATE:04/03/2014 "` °-'' '` d '=ACCOUNT COD TRANS Ot 4 4 § — .ANIOUNTdDUE; '4 Air Handling Unit up to 10,000 cfm 224-00000-425604 1006 37.00 First Appliance Fee 224-00000-425604 1006 80.00 • Heat pump 224-00000-425604 1006 18.50 State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 16.26 Technology fee(5%of permit total) 100-00000-425605 2099 6.78 TOTAL DUE: 158.54 . W..MENTI °.YO jr.,ASTETr erRi. , 4$ ,,. ... . 2;„,.> i -- AMOUNT PAID:rr PAYMEN7_TNPE �,�•I:PAYOR"�:u'CASHIER:CCARPENTER.. '��ask''.«SYk>COMMENTS _,,ter .��:a=.�rd8' . ,� ,�kg,.�`; ?j Cash DUTSON CORY J 158.54 TOTAL PAID: 158.54 • • • • • • • • Mechanical Permit Application DEPARTMENT USE ONLY SPRINGFIELD CITY OFSPRINGFIELD, OREGON Penult no.: S -( U t � '7 23 225 Fifth Street• Springfield,OR 97477 • PH(54I)726-3753 • F A X(5 4 1)7 2 6-3 6 8 9 'v p EGON Date: 9 I'S f 14 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. CATEGORY OF CONSTRUCTION FEE SCHEDULE 9 Residential ❑Government ❑Commercial Residential Qty. Cea ost Total cost( JOB SITE INFORMATION AND LOCATION First Appliance / $80.00 $ 'O Job site address: 710 6 st Furnace/burner including ducts and vents City: OR 797% lip to look BTU/hr. $18.50 $ Ci State: ZIP: q Over 100k BTU/hr. $22.00 $ Reference: Taxlot.:170Z35310330p Heaters/stoves/vents DESCRIPTION OF WORK Unit heater $18.50 $ •t st311 2x Air b-cndlt(S a Z x hest pvmps Wood/pellet/gas stove/flue $42.00 $ Repair/alter/add to heating appliance/ refrigeration unit or cooling system/ $80.00 $ PROPERTY OWNER absorption system Name: GprU Dose Evaporated cooler $14.50 $ Address: 71 9 $t Vent fan with one duct/appliance vent $10.00 $ Hood with exhaust and duct $14.50 $ City: Spriiw F ieI) State: OR. ZIP: 974x$ Floor furnace including vent $80.00 $ - Phone:%-810- gSi3 Fax: - - Gas piping E-mail: One to four outlets $7.50 $ This installation is being made on property owned by me or a Additional outlets(each) $4.50 $ member of my immediate family, and is exempt from licensing Air-handling units,including ducts requirements under ORS 701.010. Up to 10,000 CFM $12.00 $ Signature: Over 10,000 UM $22.00 $ CONTRACTOR INSTALLATION Compressor/absorption system/heat pump Up to 3 hp/IOOk BTU $18.50 $7Y Business name//l/8 1-- Up to 15 hp/500k BTU $32.00 $ Address: Up to 30 hp/1,000 BTU $47.50 $ City: I State: ZIP: Up to 50 hp/1,750 BTU $62.50 $ Phone: - - Fax: - - Over 50 hp/I,750 BTU $104.50 $ _ E-mail: Incinerators /cF�l 2S_,1nv Domestic incinerator I $22.50 $ CCB license no.: Commercial Print name: Enter total valuation of mechanical system and installation costs$ Signature: Enter fee based on valuation of mechanical system,etc. $ Miscellaneous fees Items Cost Total ea. cost Reinspection $80.00 $ Specially requested inspections(per hr.) $80.00 $ Regulated equipment(unclassed) $14.50 $ Each additional inspection:(I) $80.00 $ APPLICANT. USE (A)Enter subtotal of above fees(or enter set minimum fee of $80.00) $ (B)Investigative fee(equal to[A]) $ (C)Enter 12%surcharge(.12 x[A+B]) $ l401 (D)Seismic fee, I%(.01 x[A]) $ (E)Technology Fee(5%of[A]) $ (7 440-2545-1(4/1/2013/COM) TOTAL fees and surcharges(A through E): $2(