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Home My WebLink AboutPermit Mechanical 2019-12-31OREGON Web Address: www.springfield-or.9ov Building Permit Residential Mechanical Permit Number: 811-19-OO289O-MECH IVR Number: 811008164012 City of Springfield Development and Public Works 225 Fifth Street Springfield, OR 97477 54L-726-3753 Email Address: permitcenter@springfield-or. gov SPRINGFIELD $ Permit Issued: December 3t,z0tg TYPE OF WORK Category of Construction: Single Family Dwelling Submitted Job Value: $0.00 Descriptaon of Work: Installation of wood stove. Type of Work: Alteration ,OB SITE INFORMATION Worksite Address 3354 MONTEBELLO AVE Springfield, OR 97477 Parcel 1702 193 10 1001 Owner: Address: AKERS PAMELA M & THOMAS C 3354 MONTEBELLO AVE SPRINGFIELD, OR 97477 LICENSED PROFESSIONAL IN FORMATION Business Name OWNER - Primary License CCB License Number 000000 Phone PENDING INSPECTIONS Inspection 2999 Final Mechanical 2300 Rough Mechanical Inspection Group Mech Res Mech Res Inspectaon Status Pending Pending 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. Sched ule or track inspections at www. build ing permits.oregon. gov Call or text the word "schedule" to 1-888-299-2821 use IVR number: 811008164012 Schedule using the Oregon ePermitting Inspection App, search "epermitting" in the app store Permits expire if work is not started within 180 Days of issuanc€ or ifwork is suspended for 180 Days or longer dependang on the issuing agency's policy. All provisions of laws and ordinances governing this type of work will be complied with whether speclfied herein or not. Granting of a permit does not presume to give authority to violate or cancel the proyisions 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 Utility Notification Center. Those rules are set forth in OAR 952-OO1-OO1O through OAR 952-OO1-OO9O. You may obtain copies of the rules by calling the Center at (5O3) 232-L947. All persons or entities performing work under this permit are required to be licensed unless exempted by ORS 7O1,O1O (Structural/Mechanical), ORS 479.540 (Electrical), and ORS 693.010-O20 (Plumbing). Printed on: t2l3vl9 page 1 of 2 C:\myReports/reports//production/01 STANDARD -r,-./ I Permit Number: 81 1-19-0O2890-MECH Page 2 of 2 Fee Description Technology Fee Balance of minimum permit fees - mechanical Wood/pellet stove State of Oregon Surcharge - Mech (L2o/o of applicable fees) Printed on: l2l3U19 Quantity Fee Amount $s.10 $48.00 $s4.00 $12.24 $ 119.34Total Fees: C :\myReports/reports//production/01 STAN DARD 1 Page 2 of 2 PERMIT FEES SPRINGIIELD tfi Transaction Receipt 81 1 -19-002890-MECH IVR Number: 81100816401 2 Receipt Number: 473426 Receipt Date:12131119 City of Springfield Development and Public Works 225 Fifth Street Springfield, OR 97477 541-726-3753 permitcenter@springfield-or. govOREGON www. springf ield-or.9ov Woksite address: 3354 MONTEBELLO AVE, Springfield, OR 97477 P arcr.l'. 17 021931 0 1 00 1 Transaction Units date 't2t31t19 1.00 Ea 12t311',!9 1.00 Automatic Description Wood/pellet stove Balance of minimum permit fees - mechanical State of Oregon Surcharge - Mech (12% of applicable fees) 224-00000-425604- 1 03 1 224-00000- 425604-'1 03 1 82 1 -00000-2 I 5004-0000 204 -00000 - 42560 5-0000 12t31t19 't.00 Ea 't2t31t19 1.00 Automatic Technology Fee Fees Paid Account code Fee amount $54.00 $48.00 $12.24 $5.1 0 Paid amount $54.00 $48.00 $12.24 $5.10 Payment Method Credit card authorization: 0041 30 Payer: Thomas Akers Payment Amount:$1 19.34 Cashier: Thayne Smith Receipt Total:$119.34 Printed: 12l31/'19 1:05 pm Page 1 of 1 Fl N_Transaction Recerpt_pr [t^r Crrv or SpntxcFIELD, Onnc;tlN Mechanical Permit .Errca@ 225 Fiffn SfiEd . Springfield, OR 9477 . PH(541)72G3753 . FAX(541r26-3689 This permit is issued undcr OAR 91&4rm{n50. Permits crpire if work b not stertcd within 180 days of bsurncc or if work b suspendcd for 180 dry* ec4) CATEGORY OF CONSTRUCTION fin"ria*tia IGovemment E Commercial JOB SITE INFORMATION AND LOCATION Job site address: 'l State: fllfl ztP:t147? ReferJJ"",J Taxlot. DESCRIPTION OF WORK PROPERTY OWNER q '-2 t7 Address:itP city: (lSrlt a S;o)J State: ff ztP:Ci74?1 Fax: E-mail: This ls being made me or a member of my immediate licensing requirements under I .0 I CONTRACTOR INSTALLATION Business name Address: ^/City:sl State:ZIP: Phone:Fax: E-mail: CCS fi"."r. n;/ Print name Sigrature: FEE SCHEDULE Residential 00.Cost ea, Totrl cost Fint Annliance ir 02,oo s Furnace/burner including ducts and vents Up to l00k BTU/hr $23.00 $ Over l00k BTU/hr $26.00 $ flentex/sloves/vents []nit heater $23.00 $ Wood/pellet/gas stove/fl ue I s54.00 $ 6'9 Evaporated cooler il9.00 $ Vent fan with one duct/appliance ll3.00 $ Hood with exhaust and duct Ir9.00 $ One to four outlets 89.00 $ Additional outlets (each)05.00 $ Upto 10,000CFM il5.00 $ Over 10,0O0 CFM t26.00 $ Comnressor/ehsorotion svstem/heat oumo Up to 3 hp/100k BTU t23.00 $ Up to 15 hp/500k BTU i4r.00 $ Up to 30 hp/1,000 BTU t61.00 $ Up to 50 hp/1,750 BTU t7E.00 $ Over 50 hp/I,750 BTU il32.00 $ Incinerators Domestic incinerator [26.00 $ Commercial Enter total valuation ofmechanical system and installation costs $ Enter fee based on valuation ofmechanical system, etc.$ Miscellaneous fees Cost cfl. Total cmt Reinspection il02.00 $ Specially requested inspections (pet il02.00 $ Regulated equipment (unclassed)il9.00 $ Each edditionel inspection: (l)i102.00 $ DEPARTMENT USE (A) Enter subtotal ofabove fees (or enter set minimum fee of $ {02.00)$ (B) Investigative fee $ (C) Enter l2% surcharge (. 12 x [A+B])$ (D) Seismic fee, I % (.01 x [A])$ (E) Technolosi Fee (s% oflAl)$ TOTAL fees and surcharges (A through E):$ DEPARTMENT USE ONLY Permit no.: \ 1 - O O'ZZy>4 Date: 42-/ 3t,/r= [^ast editcd 7/l/ml9 BJmc6 5Y. ltj 'N A{P ctw: (f)ilt) a on s Property Owner Statement Regarding construction Responsibilities Oregon Law requires residential construction permit applicants who are not licensed with the conitruction contractors Board to sign the following statement before a building permit can be issued. (ORS 701.325 (2ll This statement is required for residential building, electrical, mechanical, Licensed architect and engineer applicants, exempt from licensing under and plumbing permits. ORS 701.010 (7), need not this statement. This statement will be filed with the permit.submit 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 struclure 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. lf I hire subcontractors, I will hire only subcontractors licensed with the Construction Contractors Board. lf 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 lnformation and I hereby certify that the information on Notice to Homeowners About Construction Responsibilities' this homeowner statement is true and accurate. at-9 Print Name of Permit APPlicant t/L wl Signature of Permit APP|icant Permit #: Address: lssuedoy:11 * oate: fz/Zt/t? Date This Copy for Permit Offices SS4 $+*rrrrsetr-o Avr lnformation Notice to Owners About Construction Responsi bi I ities (oRs 701.325 (3)) CONSTRUCTION CONTRACTORS BOARD PO Box 14140, Salern, OR 9730$5052 Telephone: 503-378-462'1 - Fax: 503-373-2007 Website Address: www.oregon. gov/ccb o o o a a Homeowners acting as their own geneial contractors to construct a new home or make a substantial improvement to an existing structure, can prevent many problems by being aware of the following responsibilities: Homeowners who use labor provided by workers not licensed by the Construction Contractors Board, may be considered an employer, and the workers who provide the labor may be considered employees. As an employer, you must comply with the following: Oregon's Withholding Tax Law: Employers must withhold income taxes from employee wages at the time employees are paid. You will be liable for the tax payments even if you don't actually withhold the tax from your employees. For more information, call the Department of Revenue at 503-378-4988. Unemployment lnsurance Tax: Employers are required to pay a tax for unemployment insurance purposes on the wages of all employees. For more information, call the Oregon Employment Department at 503-947 -1 488. Oregon's Business ldentification Number (BlN): is a combined number for both Oregon \Mthholding and Unemployment lnsurance Tax. To file for a BlN, go online to the Oregon Business Registry. For questions, call 503-945-8091. Workers Compensation lnsurance: Employers are subject to the Oregon Workers Compensation Law, and must obtain Workers Compensation lnsurance for their employees. lf you fail to obtain Workers Compensation lnsurance, you could be subject to penalties and be liable for all claim costs if one of your workers is injured on the job. For more information, call the Workers Compensation Division at the Department of Consumer and Business Services at 800'452-0288. Tax Withholding: Employers must withhold Social Security Tax and Federal lncome Tax from employee wages. You may be liable for the tax payment, even if you didn't actually withhold the tax. For a Federal EIN number, go online to www.irs.gov. o Other Responsibilities of Homeowners: Code Compliance: As the permit holder for a construction project, the homeowner is responsible for notifying building officials at the appropriate times, so that the required inspections can be performed. Homeowners are also responsible for resolving any failure to meet code requirements that may be found through inspections. property Damage and Liability lnsurance: Homeowners acting as their own contractors should coniact iheir insurance agent to ensure adequate insurance coverage for accidents and omissions, such as falling tools, paint overspray, water damage from pipe punctures, fire, or work that must be redone. Liability lnsurance must be sufficient to cover injuries to persons on the job site who are not otherwise covered as employees by Workers Compensation Insurance. Expertise: Homeowners should make sure they have the skills to act as their own general contractor, and the expertise required to coordinate the work of both rough-in and finish trades. e o ,r--^^^+, a'.rnar :dnntad a-7n16 This Copy for Permit