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Home My WebLink AboutPermit Mechanical 2014-09-03- 225 Fifth St LSPRINGFIELD CITY OF SPRINGFIELD Springfield,oR97477 vs�Phone: 541-726-3753 OREGON Building /Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2014-01897 w v.spdngfield-ocgov permitcenter@springfield-or.gov SII PROJECT STATUS: Issued ISSUED: 09/03/2014 EXPIRES: 03/01/2015 STATUS DATE: 09/03/2014 APPLIED: 09/03/2014 SITE ADDRESS: 1610 17TH ST, Springfield, OR 97477 SCOPE: Mechanical Only ASSESOR'S PARCEL NO: 1703253103200 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Bath fan and range hood OWNER: WALDO ELDON HUNTER REVOCABLE LIVING TRUS Phone Number: ADDRESS: 6898 GLACIER DR SPRINGFIELD OR 97478 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. Owner or Contractor Signature N` 0,171 G E: TI !IS PERMIT SHALL EXPIRE IF THE WORK AUTHORIZED UNDER THIS PERMIT IS NOT Wk,11VIENCED OR IS ABANDONED FOR ANY 180 DAY PERIOD. Date i1 P! HON: Ore{ton law requires you to rut',,: adopted by the Oregon Utility d, in Center. Those rules are set forth in C)A 062-001-0010 through OAR 952-001- 0090. You may Obtain copies of the rules by calling the center. (Note: the telephone number for the Oregon Utility Notification Center is 1-800-332-2344). Springfield Building Permit 9/3/2014 10:46'21AM Page 1 of 1 SPRINGFIELD DATE: 09/03/2014 CITY OF SPRINGFIELD 1-�—+ "}— TRANSACTION RECEIPT 225 Fifth St Springfield,OR97477 OREGON 811-SPR2014-01897 541-726-3753 wanv.springfield-or.gov 1610 17TH ST peanitc nter@spdngfield-or.gov RECEIPT NO: 2014001925 RECORD NO: 811-SPR2014.01897 DATE: 09/03/2014 DESCRIPTION ACCOUNT CODE/TRANS CODE AMOUNT DUE' Continuing Education Fee 224-00000-425606 2.50 First Appliance Fee 224-00000-425604 1006 82.00 Single -duct exhaust (bathrooms, toilet compartments, utility room: 224-00000-425604 1006 10.00 State of Oregon Surcharge (12% of applicable fees) 821-00000-215004 1099 11.04 Technology fee (5% of permit total) 100-00000-425605 2099 4.60 TOTAL DUE: 110.14 Cash WALDO ELDON HUNTER REVOCABI LIVING TRUS 110.14 TOTAL PAID: 110.14 Mechanical Permit Application DEPARTMENT USE ONLY SPRW GFlELG 0 1 ! Permit no.: (�S 225 Fifth Street ♦ Springfield, OR97477 ♦ PH(541)726-3753 ♦ FAX(541)726-3689 `" Date: 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 QF CONSTRUCTION Residential ❑ Government ❑ Commercial JOB SITE INFORMATION AND LOCATION, _ Job site address: 111t. City: `' F ` State: ZIP:0' -Reference:-T-axlot.: DESCRIPTION.OF WORK c � s d ;PROPERTY' OWNER Name: Fldoiu Address: p Ilk - City: 5(�� (c� State: C),1? ZIP: 9-/ % Phone? `(�- S Fax: 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 �y¢t Signature: ea, y l � ,`CONTRACTOR JNSTALLATION Business name: 6 Address: City: City: State: ZIP: Phone: Fax: E-mail: CCB license no.: Print name: Signature: 440-2545-)(5/21/2014/COM) FEE SCHEDULE, Res[dentlal Qty Cpst '• ,ea, Total ,.cost`.-'. First Appliance $82.00 Furnace/burner including ducts and vents Up to 100k BTU/hr. $19.00 $ Over I 00 BTU/hr. $22.00 $ -Heaters/stoves/vents Unit heater $19.00 $ Wood/pellet/gas stovelflue $43.00 $ Repair/alter/add to heating appliance/ refrigeration unit or cooling system/ absorritions stem $82.00 $ Evaporated cooler $16.00 $ Vent fan with one duct/appliance $10.00 $ Hood with exhaust and duct $15.00 $ Floor furnace including vent $82.00 $ Gas pipin One to four outlets $8.00 $ Additional outlets (each) I 1 $5.00 $ Air -handling units including ducts Up to 10,000 CFM 1 $12.00 $ Over 10,000 CFM 1 1 $22.00 $ Com ressor/absor tions stemlheat DUMD Up to 3 hp/100k BTU 1 $19.00 $ Up to 15 hp/500k BTU $33.00 $ Up to 30 hp/1,000 BTU $49.00 $ Up to 50 hp/1,750 BTU $64.00 $ Over 50 hp/1,750 BTU $107.00 $ Incinerators Domestic incinerator $22.60 $ Corilmerciai`:'- ` Enter total valuation of mechanical system and installation costs $ _ Enter fee based on valuation of mechanical system, etc. $ Miscellaneous fees tem Cgst ea. '. - Totaf east ` Reinspection $82.00 $ Specially requested inspections (pe $82.00 $ Regulated equipment (unclassed) $15.00 $ Each additional inspection: (1) $82.00 $ TA TL(CANT'l7SE (A) Enter subtotal of above fees (or enter set minimum fee of $ 82.00) $ (B) Investigative 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]) $ �(<✓ (F) Continuing Education Fee $2.50 $2.50 TOTAL fees and surcharges (A through F): $`/( �I' 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: ❑ 1 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. [old 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. f UC2J) 44 j f,2_ Prin Name of Permit Applicant ❑��, ignature of Permit Applicant Permit #: 5/`/ ® / 89 i Address: /(/L SPr� v ai-e- 171(7-2 Issued by: Date: 3 This Copy for Permit Offices