Loading...
HomeMy WebLinkAboutPermit Mechanical 2014-5-19 SPRINGFIELD 225 Fifth St 'A CITY OF SPRINGFIELD Springfield,OR 97477 • Et"' OREGON' 'J°L Phone: 541-726-3753 Building / Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2014-01095 www.springfield-or,goy permitcenter@springfield-or.gov PROJECT STATUS: Issued ISSUED: 05/19/2014 EXPIRES: 11/14/2014 STATUS DATE: 05/19/2014 APPLIED: 05/19/2014 SITE ADDRESS: 1135 B ST,Springfield,OR 97477 SCOPE: Mechanical Only ASSESOR'S PARCEL NO: 1703351418800 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: New heat pump-electrical by contractor OWNER: LEWIS WALLACE J 8 JUDITH K LIFE ESTATE Phone Number: ADDRESS: 1135 B ST SPRINGFIELD OR 97477 • CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone Mechanical Contractor OWNER CCB 000000 08/01/2025 INSPECTIONS REQUIRED 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. ✓J/ /� //N 42/� °`'� (-N / 7- 7174 / Owner or Contractor Signature Date • ATTENTION: Oregon law requires you to NOTICE: follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth THIS PERMIT SHALL EXPIRE IF THE WORK In OAR You may obtain copies of the rules by AUTHORIZED UNDER THIS PERMIT IS NOT In OA 9 the center.0(Note: he telephone hruley COMMENCED OR IS ABANDONED FOR ANY 180 DAY PERIOD. number is 14300-332-2344). r fcatio • Springfield Building Permit 5/19/2014 9:23:29AM Page 1 of 1 • SPRINGFIELD CITY OF SPRINGFIELD .A A aft,- 225 St TRANSACTION RECEIPT SpringFfielifth d,OR 97477 'ifiii\er-Ef 541-726-3753 ik h OREGON 811-SPR2014-01095 www.springfield-or.gov 1135 B ST perrnitcenter©springfield-or.gov RECEIPT NO: 2014001088 RECORD NO:811-SPR2014-01095 DATE:05/19/2014 DESCRIPTION_ .. _ - _ _ . . .. -. ,_ i .4 ACCOUNT CODE/TRANS CODE , ... . AMOUNT DUE First Appliance Fee 224-00000-425604 1006 80.00 State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 9.60 Technology fee(5%of permit total) 100-00000-425605 2099 4.00 TOTAL DUE: 93.60 LPAYMENT.TYPE - 'PAYPR_._9/■8HIER:CCAFTENTER ,i,,-,,,i„,„ COMMENTS,_ OUNT_PAID , ,i....L.i.j Cash LEWIS WALLACE J &JUDITH K LIFE 93.60 ESTATE TOTAL PAID: 93.60 f Mechanical Permit Application DEPARTMENT USE ONLY SPRINGFIELD r, _ r(` C TI plISERINCFIELD OE ®N .. -�' Permit no.: S/ - /6#1:7S R 225 Filth Street • Springfield,OR 97477 • I H(541)726 3753 • FAX(54l)726-3689 la OREGON Date: C//9//Y This permit is issued under OAR 918-440-0050. Permits expire if work is not started within 180(lays of issuance or if wort: is suspended for 180 days. CATEGORY OF CONSTRUCTION FEE SCHEDULE ❑ Residential ❑ Government ❑ Commercial Residential QIy, Cost Total M. 1051 JOB SITE INFORMATION AND LOCATION First Appliance In $80.00 ®ry Job site address: 11 3 S Biz Furnace/burner including ducts and vents City:51 r i 2,7cpr ce p State: 0/7E- ZIP: 9?LI77 up to I OOk BTU/hr. $18.50 S Over 100k 13111/hr. $22.00 $ Reference: / 70,E ?S/c( ]axlot./STO ) Heaters/stoves/vents DESCRIPTION OF WORK Unit heater $18.50 $ • _Ina.4L,r--NQAT---...J1W Wood/pellet/gas stove/flue $42.00 $ 12epuir/alter/add Io heating appliance/ refrigeration unit or cooling system/ $80.00 $ PROPERTY OWNER absorption system Name: 1tf ) 1,y /-Ch.,/ s Evaporated cooler 514.50 $ Vent fan with one duct/appliance vent 5•0.00 $ Address: // 35-- re 51 Flood with exhaust and duct $14.50 $ CiryS O17vC,Fi c�0 State:/9/ ZIP: G17 [17 r F t- l Floor furnace including vent $80.00 S Phone:j"yf 72/7_ 7 fla Fax: - - Gas piping -- — E-snail: 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 I0.000 CFM $12.00 .$ Signature: Over 10.000 CFM $22.00 $ CONTRACTOR INSTALLATION Compressor/absorption system/heat pump Business name:0 0_,/,,(1 L Up to 3 hp/100k R'fU / $18.50 Up to U hp/500k BTU $32.00 S Address: Up to 30 hp/1,000 131U $47.50 $ City: State: ZIP: Up to 50 hp/I.750 BTU $62.50 $ Phone: - - Fax: - - Over 50 hp/I.750 (3T(J $104.50 $ E-mail: Incinerators Domestic incinerator $22.50 $ CCB license no.: ---- Commercial Print name: - Enter total valuation of mechanical system and inslallatiomeosts$ Signature: _ Enter fee based on valuation of mechanical ssteni.etc. S Miscellaneous fees Items Cost Total ca. cost Reinspection $80.00 $ Specially requested inspections(per hr.) $80.00 $ Regulated equipment(u tclassed) 514.50 $ Each additional inspection: (I) $80.00 $ . APPLICANT USE (A) Enter subtotal of above fees(or enter set 0 minimum lee of $00_00) $ (B) Investigative fee(equal to [AI) $ (C)Enter 12%surcharge(.12 x [A+13]) $ (D)Seismic lee. 1%(.01 x [.Al) $ T (E)Technology Fee(5%of[AD $ 17.25 440-2545-3(4/1/2013/COb1) 'PO'PAL fees and sin-charges(A through B): $ � . 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 iri, 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. (Al/I L'->, LL w I S Print Name of Permit Applicant • Signature emit Applicant Date Permit#: 5/q —/v 5 5 of Address: //I S,'ktN4K�7o � �7Y�7 N: � ° • Issued by: Date: 57/9(/Y 1859 • • This Copy for Permit Offices