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Home My WebLink AboutPermit Mechanical 2008-3-6 " Status Issued CITY OF SPRINGFIELD. Building/Combination Permit PERMIT NO: COM2008-00300 ISSUED: 03/03/2008 APPLIED: 03/03/2008 EXPIRES: 09/06/2008 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 InspeCtion Line SITE ADDRESS: 4141 CAMELLIA ST ASSESSOR'S PARCEL NO.: 1702323303801 Springfield TYPE OF WORK: Heating System TYPE OF USE: Alteration Residential PROJECT DESCRIPTION: , Gas Furnace Owner: BALES MATTHEW M & MICHELLE E Address: 4141 CAMELIA ST SPRINGFIELD OR 97478 Phone Number: 541-736-5185 Contractor Type Mechanical . I CONTRACTOR INFORMATION' Contractor License ASSOCIATED HEATING & AIR CONDITIO 106275 BUILDING INFORMATION' Expiration Date 08/31/2008 Phone 541-683-2590 # of Units: # of Stories: Primary Occupancy Group: Height of Structure Secondary Occupancy Group: Type of Heat: Primary Construction Type '. Water Type: Secondary Construction Type: Range TI: # of Bedrooms: r 1lAir'gyCll : l-10\\C~:. \-\~\..\.. E'i-?\RE \ n~ittf5l~ uilding: n/a .'1-,,11" C. T \f P~n -,,;\ 1\-\\S ;;;\IED \}~D\:; ~~~~ENT INFORMATION I , . ~\}~\'J\E~CED OR~\OD. . REQUIRED PARKING Frontyard SetbacR-:'O:{ "\ 80 D~'I( ?E Ove!:.lay.Dist: Total: Side 1 Setback:. ~N # Street Trees Rqd: H~ne~~'app~~: Side 2 Setback: Paved Drive Rqd: ~ ~e~iJ-~f.:)'\\\\ ~\n Rearyard Setback: % of Lot Coverage: O~e900 \e: \\\e O~e ~ ~e set \0 (y\_ . Solar Setbacks: N\\O\'\" AO?WO 'o~ se ~u\eS ~~ gS?"'O 'o~ ~"\".,.€ . _c au ,.,.\\0 ",'00. _ rll\eS I' t\>.J 0\"'" \\I\v.J.J ;\ \,,- \\1;;, I PUBLIC IMPROVEME~~il a\\00 C~,\_OO'\ ~ CO?\6S 013 \8\e?~O ~\O~ .' ~u,~c . gS~-O ~a\0 ;\13'. \~ \,\o\\\\ce: '", Op..~ .)S~~w':iI~,\~fPe.~O \)\\\\\~ htl,\. . . ~\' O. ,0 Ce09.00 ?.?..~'" IJ . .. . OO~a\\\012~~~~~~~~~~ . . . rl\'oe~ \ ~e\ 's . . ~u\,. Ce0 . . Lot Size: . Sq Ft Ist Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: . Occupant Load: Street Improvements: Storm Sewer Available: Special Instruction: Notes: . I Valuation Description I Description Type of Construction $ PerSq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Paee 1 of 3 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Total Value of Project ~ Fee Description ~Mechanical Issuance Fee~ + 10% Administrative Fee + 12% State Surcharge + 5% Technology Fee Furnace - up to 100,000 btu Minimum/Adjustment Mechanical + 10% Administrative Fee + 12% State Surcharge + 5% Technology Fee Perm Serv/Fdr 200 amps or less Amount Paid Date Paid $20.00 $5.00 $6.00 $2.50 $14.00 $36.00 $7.00 $8.40 $3.50 $70.00 3/3/08 3/3/08 3/3/08 3/3/08 3/3/08 3/3/08 3/6/08 3/6/08 3/6/08 3/6/08 Total Amount Paid $172.40 I Plan Reviews I CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2008-00300 ISSUED: 03/03/2008 APPLIED: 03/03/2008 EXPIRES: 09/06/2008 VALUE: ., Receipt Number 2200800000000000272 2200800000000000272 2200800000000000272 2200800000000000272 2200800000000000272 .\ 2200800000000000272 3200800000000000150 3200800000000000150 3200800000000000150 3200800000000000150 To Request an inspection call the 24 h"ouf recording at 726-3769. All inspections requested before 7:00 a.m. will be made the same working day, inspections requested after 7:00 a.m. will be made the following work day. . ~eouire~nsnections I Rough Mechanical: Prior to Cover Final Mechanical: When all mechanical work is complete. Electric Service: Approval required prior to utility company energizing service. Pa2;e 2 of 3 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line CITY OF SPRINGFIELD I Building/Combination Permit PERMIT NO: COM2008-00300 ISSUED: 03/03/2008 APPLIED: 03/03/2008 EXPIRES: 09/06/2008 VALUE: 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 of 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 Contractors Signature Page 3 of 3 Date Construction Contractors Board 700 Summer St NE Suite 300 PO Box 14140 Salem OR 97309-5052 Phone: 503-378-4621 Web Address: www.ccb.state.or.us permit~cm~- ciJ3a-D Address: ~ I Lf{' ~ Q.L i'{A..- Issued by: 0VY1 (' J f\I"'..-' Date: <..3/ Co I' 0 Es: /J Statement: Infolll.ation Notice.to ,Property Owners About Construction Responsibilities . ~. . Note: Oregon Law, ORS 701.055(4) requires residential construction permit applicants whoare not licensed with the Construction Contractors Board to sign the following statement before a building 'permit can be issued. This statement is requiredfor 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. Fill in the appropriate bla.TIks and initial boxes I and 2, and either box3A.or-3B: ~f 1 own, reside in, or will reside in the completed structure. , D 2." 1 understand that 1 must become licensed asa construction contractor if the structure is sold or . . offered for sale before or on completion. D 3A.'My general contractor is (Name) (CCB #) 'I will instruct my general contractor ~hat all subcontractors who work on the structUre must be licensed:with the Construction Contractors Board. OR ~: I will be my own.general contractor. C W-~\ GaJ2') . . t >.' If! hire'subcontractors, 1 will hire only subcontractorsJicensed with the Construction Contractors . Board. If I change my mind and hire a general contractor, I will contract with a contractor who is licensed with the CCB and will immediately notify the office issuing this building permit. of the name of the contractor. . . .,' I hereby certify that the'above information is correct and that I have'read and do understand the Information ,Notice to Property Owners about Construction Responsibilities on the reverse side ofthis form. JJ"~h~ i:f)rk~ , V (SlgnatlJe-Otpermlt apphcant) 3-to~O~ (Date) (white copy to issuing agency permit file, pink copy to applicant.) _ PropertLowner.doc 06-01-04 Acting'ss -Y.(hiF' ,', Contractor? , " ' \' \- ,'-' - "INFORMATlo~r NOTICE ,TO ,PROPERTY OWNERS ABOUT CONSTRUCTION RESPONSIBILITIES I' ,:' NOTE: This Information Notice to Property Owners about Construction Responsibilities was developed by the Construction Contractors Board in accordance with 701.055(5), passed by the 1989 Oregon Legislature. you are as your owncontr~ctor to construct a ,new can prevent'rtmny problems:by being: aware 1, '. , or make a substantial improvement to an existing responsibilities and concerns: Employer ...', ! .ruled to, b,e an "employ, er" with the Construction a'residentia1 structure,' ". 'II. "l.-i., . , ' . - .",.. contractors YOt!: contrfl-qt wit~ will be,."employees" if to do, labor iri'constr:u'cting or to assist in the YOlJ must . th~ foliowing: . . .... , ~ you ,ust? ~ . . .~ income taxes from employee wages at the time even if you don;t actually withhold the tax from your 'at503~378-4988: . As an employees. For more inf01mation, a tax for unemployment insurance purposes Employment at 503-947-1488. on "t' . ;":..L-:: ~~".~'~r.-.'.. . " ~ . ., i~:: -.... _ ' ~. ~ ..' .. IdeJ1tificnotion ,Number (BIN) Tax. To file for a can a compined-number'. {or"both Oregon: Withholding and or w\vw.doLstate.oLus/fonnsn3.v.htmll for the ~, . ....' . ~ .}.-:.; and mu~t Insurance: As an employer, you are , cmppen~at~on ins!-lrance for , subjeCt t6 perfalhes . , call tbe ,W orkers 1 to the Oregon Workers' Compensation Law, I~ you faiI,to work,er( compensation if'one of your empioyeeS'is'injured on the' ' at the Department 'of ConsUmer ana Business job. For Services at 503-947-7815. ' . ".: ;:',,;' ..... federal income tax employees' wages~.. the tax, For a Federal EIN number, can the U,S. SerVice: As ap You will be liable for the tax payment even if you didn't IRS at or visit their-web site at , .~- .; ~' f ..~ ' '\ :' '_ ..- , ' Code As the pennit holder for requirements that may he to xour attention ',", ' . "",;" ". :. . ",'.' . . .. are for imy failure to meet code · , ' 'agentto ~ee if you have'adequateihsurartce water damage pipe pUnctures, fire or ~md coverage for work that mus!.?~ , ~I...- '- Make sure you and omissions such as \. time to your . * '" , ' ' ,.. .', '. H' you have' the skills to as' your O\vn to notify building officials as to coordiI'iate the can of rough-in inspections. have Box 14140, questions call the 97309-5052. 06-01-04 (503-378-4621) or at PO . ,.;-, " ~ ZON INITIALS DATE SOURCE 225 FIFfH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 ELEl.:l.KlC~PERMIT APPLICATION City Job Number (' Dnll 2 r;n ,Z'" - c'JQ2>()D 1. ).,,/1 L/ /rllJiM~/l"Ci if " , - LEGAL DESCRIPTION: / ~OY\\^-o,c"j& r1K, 9747R vg (I" JOB DESGRIPTION: ~l/)\v-e h)vv\deQ Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. 2. Electrical Contractor ~ddreSS C~ / Phone / Signature of Supervising Electrician Owners Name ~d~tJt[, I~~!e ~ Address 4/4! f!~.du c.-~f- "City2flv\~~~_~& Phone 73fo ~ $I tiS OWNER INSTALLATION The installation is being made on property I own which if1iS not inte~ded fo sale, lease or re,nt. o e SI' aJ: /' d(" ~ ' i /' '1IY/~-:2 V v ~ .,- .....-- " Inspection Request: 726-3769 "2}(~/o<:( ,Date 3. A. Service Included 1000 sq. ft.. or less Each additional 500 sq. ft, or portion thereof Each Manufact'd Home or Modular Dwelling Service or Feeder $117.00 $ 21.00 $55.00 , B. 200 Amps or less 201 Amps to 400 Amps 40 I Amps to 600 Amps 601 Amps to 1000 Amps Over 1000 AmpsN oIts Reconnect Only II?> k $ 70.00 J' " $ 83.00 $138.00 $180.00 $413.00 $ 55.00 x c. Installationi~Ve'iMTd6l~ Qe~tj"!wrequires you to' 200 Amps N~ft ~~Ie~ adopted .bY the Or$~6rf)l!))tiIitv 201 Amps tft ~:k~ enter. T~,ose rUles~IfliW forth l::-OOl-OOlO (," uU!:I1 I o~ Q~OOl- 401 AmpsOOtiOQ ~may obtain cop' f 'l'I'U:OO 'I" IG3 0 e rules oy Over 600 Q&btt WfiWee~tm'tabd>ive. teJe h D. New Alteration or Extension Per"Panel One Circuit Each Additional Circuit or with Service bl@t?eW~ermit $ 48,00 $ 4.00 E. Pump of~~WCED OR /S ABANDONE" H)9P Sign/Outiin'e Llgll~Y PER/DO. $ 55.00 Limited Eriergy/Residential $ 28.00 Limited Energy/Commercial $ 50.00 Minimum Electric Permit Inspection Fee is $50.00 + Surcharges 70.00 3 . 7)'0 g-.LjO 7-00 ~~" qO. 4. 12% State Surcharge 10% Administrative Fee 5% Technology Fee TOTAL Shared Drive(T:)/Building FormslElectrical Permit Application 1-08,doc 225 Fifth Street Springfield, Oregon 97477 541-726-:3759 Phone Job/Journal Number COM2008-00300 COM2008-00300 CO M2008-003 00 COM2008-00300 , Payments: Type of Payment CreditCard cReceint 1 RECEIPT #: Description' Penn Serv/Fdr 200 amps or less + 5% Technology Fee , + 12% State Surcharge + 10% Administrative Fee Paid By MICHELLE BALES City of Springfield Official Receipt Development Services Department Public Works Department 3200800000000000150 Date: 03/06/2008 2:37:03PM Item Total: Check Number Authorization Received By Batch Number Number How Received njm 964705 In Person Payment Total: Amount Due 70,00 3,50 8.40 7,00 $88.90 Amount Paid $88,90 $88.90 Page 1 of 1 3/6/2008