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Home My WebLink AboutPermit Mechanical 2014-09-22SP 2iNGFiF.LD -' BUCK TERRY 225 Fifth St 460 S 4TH ST CITY OF SPRINGFIELD Springfield,OR 97477 r3 HUFF SHARON L Phone: 541-726-3753 OREGON Building / Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2014-02055 w .springfieid-orgov pe malicenter@spnngfield-or.gov PROJECT STATUS: Issued ISSUED: 09/22/2014 EXPIRES: 03/21/2015 STATUS DATE: 09/2212014 APPLIED: 09/22/2014 SITE ADDRESS: 460 S 4TH ST, Springfield, OR 97477 SCOPE: Mechanical Only ASSESOR'S PARCEL NO: 1703353401802 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Ductless HP OWNER: BUCK TERRY ADDRESS: 460 S 4TH ST SPRINGFIELD OR 97477 OWNER: HUFF SHARON L ADDRESS: 460 S 4TH ST Phone Number: Phone Number: SPRINGFIELD OR 97477 CONTRACTOR INFORMATION Contractor Type Contractor Name Lie Type Lic No Lic Exp Phone Mechanical Contractor OWNER CCB 000000 08/01/2025 Inspections 2999 Final Mechanical INSPECTIONS REQUIRED 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 HOME: THIS PERMIT SHALL EXPIRE IF THE WORK AUTHORIZED UNDER THIS PERMIT IS NOT COMMENCED OR IS ABANDONED FOR ANY 180 DAY PERIOD, Date A71- N1 -ION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are sot forth in OAR 952-001-0010 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 9/22/2014 2:53:1 -IPM Page 1 of 1 SPRINGFIELD -- CI"I'Y OF SPRINGFIELD TRANSACTION RECEIPT 225 Fifth St Springheld,OR97477 OREGON 811-SPR2014-02055 541-726-3753 vmnv.spnngfield-ocgov 460 S 4TH ST permitcenter@spnngfield-or.gov RECEIPT NO: 2014002102 RECORD NO: 811-SPR2014-02055 DATE: 09/22/2014 DESCRIPTION ACCOUNT CODE/TRANS CODE AMOUNT DUE Continuing Education Fee 224-00000-425606 2.50 First Appliance Fee 224-00000-425604 1006 82.00 State of Oregon Surcharge (12% of applicable fees) 821-00000-215004 1099 9.84 Technology fee (5% of permit total) 100-00000-425605 2099 4.10 TOTAL DUE: 98.44 PAYMENT TYPE PAYOR ` CASHIER: CCARPENTER COMMENTS 'AMOUNT PAID Check BUCK TERRY A 98.44 8737 TOTAL PAID: 98.44 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. 7"r A /udc,, Print Name Permit Applicant C (� r Signa ure of Pe it Applicant Permit #: Si4/ — 26 S Y Address: V6, -j S • SF- Issued by: C-bZ— Date: r o�Z❑(4 Date This Copy for Permit Offices Mechanical Permit Application DEPARTMENT USE ONLY '8PRIN6'FoIL0 Permit no.: 225 Fifth Street Springfield, OR 97477 * PH(541)726-3753 * FAX(541)726-3689 Date: !/L2— Z 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. CATEGORYAjF. CONS TRUCTION Residential El Government El Commercial JOB: SITE INFORMATION, AND LOCATION Job site address: 46n S 4-A- C, City: State: I ZIP -M4 17 Reference., Ij 1Taxlot.: DESCRIPTION OF WORK Up to I 00k BTU/hr. OWNER Name: �(,__rvw AW -I Sh2MJA &'(f Address: 4(oo -N. 04 City: S0rjM-Cjejd_ State: 6E I ZIP: Q-77 Phone:A-&- I& 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 und ORS 701.010. Signature: N14, 41 - ft,111 7777F7tONNTf ;:CONTRA OR,,lNST LATO Business name: Address: City: :=State: ZIP: Phone: Fax: E-mail: CCB license no.: Print name: Signature: 440-2545-1 (5/2 WO 14/COM) FEE SCHEDULE, ;Residential Qty,' Cost jotal, First Avoliance $8200 Furnacelburner including ducts and vents Up to I 00k BTU/hr. 1 $19.001 $ Over 100k BTU/hr. 1 $22.001 $ Beaters/stoves/vents Unit heater $19.00 $ Wood/pellet/gas stove/flue $43.00 $ Repair/alter/add to heating appliance/ refrigeration unit or cooling system/ absorritions ystem $82,00 Evaporated cooler $16.00 $ Vent fan with one ductlappliance $10.00 $ Hood with exhaust and duct $15.00 $ Floor turns" including vent T -T $82.001 $ Gas piping One to tour outlets $8.00 $ Additional outlets (each) $6.001 $ Air -handling units, including ducts Up to 10,000 CFM 1 1 $12.001 $ )400 Over 10,000 CFM 1 1 $22.001 $ Com t)ressor/absorptions ystem heat nump Up to 3 hp/100k BTU $19-.0g+-"qo0 to 15 hp/500k BTU $33.00 $ -Up Up to 30 hp/1,000 BTU $49.001 $ Up to 50 hp/1,750 BTU $64.001 $ Over 50 hp/1,750 BTU $107,00T _$ Incinerators Domestic incinerator 1 1 $22.601 $ Commercial Enter total valuation of mechanical system and installation costs $ Enter fee based on valuation of mechanical system, etc. $ :MiscellaneouS fees tem cpq Total cost Reinspection $82.00 $ Specially requested inspections (pe j $82.00 $ Regulated equipment (unclassed) $16.00 $ Each additional inspection: (1) $82.00 $ (A) Enter subtotal of above fees (or enter set minimum fee of $ 82.02) $ (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):