HomeMy WebLinkAboutPermit Mechanical 2019-11-04SPRINGFIELD
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OREGON
web Address: www.springfield-or.gov
Building Permit
Residential Mechan ica!
Permit Number: 81 1-19-OO2477 -MECH
IVR Number: 81 1068339024
City of Springfield
Development and Public Works
225 Fifth Street
Springfield, OR 97477
54t-726-3753
Email Address: permitcenter@springfield-or. gov
Permit Issued: November 04,2Ot9
TYPE OF WORK
Category of Construction: Single Family Dwelling
Submitted Job Value: $0.00
Description of Work: Ductless heat pump
Type of Work: Alteration
JOB SITE INFORI.IATION
Worksite Address
353 BLACKSTONE ST
Springfield, OR 97477
Parcel
1703233408700
Owner:
Address:
ALLENPAULW&RACHEL
353 BLACKSTONE ST
SPRINGFIELD , OR 97477
LICENSED PROFESSIONAL IN FORMATION
Business Name
ON TOP CONSTRUCTION AND
DESIGN LLC - Primary
License
ccB
License Number
209925
Phone
541-852-0474
SCHEDULING INSPECTIONS
Various inspections are minimally required on each project and often dependent on the scope of work. Contact
the issuing jurisdiction indicated on the permit to determine required inspections for this project.
Schedule or track inspections at www.buildingpermits.oregon.gov
Call or text the word "schedule" to 1-888-299-2821 use IVR number: 811068339024
Schedule using the Oregon ePermitting Inspection App, search "epermitting" in the app store
PERMIT FEES
Fee Description
Technology Fee
Balance of minimum permit fees - mechanical
Heat pump
Ventilation fan connected to single duct
State of Oregon Surcharge - Mech (L2o/o of applicable fees)
Quantity
Tota! Fees
Permits expire if work is not started within 180 Days of issuance or if work is suspended for 180 Days or longer depending on
the issuing agency's policy.
All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not.
Granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law
regulating construction or the performance of construction.
ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utiliw Notification Center. Those rules are set
forth in OAR 952-OO1-OO10 through OAR 952-OO1-OO9O. You may obtain copies of the rules by calling the Center at (503)
232-t987.
All persons or entities performing work under this permit are required to be licensed unless exempted by ORS 701.010
(Structural/Mechanical), ORS 479,540 (Electrical), and ORS 693.O1O-O20 (Plumbing),
Printed on: 11/4/19 Page 1 of 1
1
1
Fee Amount
$s,10
$66.00
$23.00
$13.00
$12.24
$ 119.34
C :\myReports/reports//production/01 STANDARD
I
SPRINGFIETD
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OREGON
www. springfi eld-or. gov
Transaction Receipt
811-19-002477-MECH
Receipt Number: 4l2g7l
Receipt Date:11t4t19
CitY of SPringfield
Development and Public Works
225 Fifth Street
SPringfield, OR97477
541'726-3753
permitcenter@springfield-or'gov
Worksite address: 3S3 BLACKSTONE ST, Springfietd, OR gt4tz
Parel: 1703233408700
Fees PaidTransaction date
11t4t19
11t4t19
11/4t19
11t4t19
11t4t19
Units
1.00 Ea
1.00 Ea
1.00 Automatic
1.00 Ea
'1.00 Automatic
Description
Heat pump
Ventilation fan connected to single duct
Balance of minimum permit fees - mechanical
State of Oregon Surcharge _ Mech (12% of
applicable fees)
Technology Fee
Account code
224 -00000425604_,t 03 1
224-00000425604_1 031
224-00000425604_1 031
821 -00000 _2 15004_OOOO
Fee amount
$23.00
$13.00
$66.00
$12.24
$5.10
Paid amount
$23.00
$13.00
$66.00
$12.24
$5.10
Payment Method: Credit card authorization:Payer:ON TOP CONSTRUCTION AND D Payment Amount:
Receipt Total
$119.34
$t 19.34
Cashier: Katrina Anderson
Printed: 1114/19 .l:S8 pm
Page 1 of 1
Fl N-Transaction ReceiPt-Pr
[r
204-00000425605_OOOO
Cmv or SpmNGFrELo, OREGoN
Mechanical Permit A lication
225 Fifth Srreet t Springfield, OR 97477 . PH(541)726-3753 . FAX(541)726-3689
This permit is issued under OAR 918440-0050. Permits expire if work is not started within 180 days of issuance or if work is
suspended for 180 days.
SPAIBOFIELO
h,
(.{
DEPARTMENT USE ONLY
Permitno.: \4OOaq??
Date:q qt\ I \r
CATEGORY OF CONSTRUCTION FEE SCHEDULE
E Government E Commercial Residential Qty.Cost
ea.
Total
cost
JOB SITE INFORMATION AND LOCATION
Job site address:ducts and vents
to l00k BTU/hr.$
ZIP:Over l00k BTU/hr $
Reference:Taxlot.
DESCRIPTION OF WORK Unit heater $
stove/flue
l$,tf,yf cooler
$54.00 $
$19.00 $
Vent fan with one I $13.00 $
PROPERTY OWNER Hood with exhaust and duct $19.00 $
Name: }1 \One to four outlets $
Address:V Additional outlets (each)$5.00 $
City:State:zIY:11
to1 CFM 5.00 $
Fax:Over 10,000 CFM $
E-mail oa-a r
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.
to3 IOOK BTU $
to 15 BTU $
to 30 I,OOO BTU $
to 50 I,750 BTU $
CONTRACTOR INSTALLATION Over 50 1,750 BTU 132.00 s
Business name:Domestic incinerator $
Address:PO Commercial
State: CIQ..ZIP:I Enter total valuation ofmechanical system
and installation costs $ _
Fax Enter fee based on valuation ofmechanical etc.$
E-mail ic,n0 Miscellaneous fees Cost
ea.
Total
cost
CCB license no.r i102.00 $
Print
Signature:Each additional
t102.00 $
ll9.00 $
1102.00 $
(A) Enter subtotal ofabove fees (or enter set
minimum fee of $$
fee $
Enter 12o/o 12x A+$
Seismic fee.7o/o .01 x $
T,Fee of $
TOTAL fees and (A E):$
Last edited 7/li20l9 BJones
il02.00 s
State:6{ZJ $26.00
123.00
rtS,
s
t26.00
t23.00
s41.00
s61.00
t7E.00
t26.00
City: i