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Home My WebLink AboutPermit Mechanical 2006-09-06N Status Issued 225 Fifth Street, Springfield' OR 541-726-3753 Phone 541-726-3676 Fax 511 -726-37 69 Inspection Line Building/Combination Permit PERMIT NO: COM2006-01 153ISSUED: 0910612006APPLIED: 09i0612006 EXPIRES: 0410212007 VALUE: SITE ADDRESS: ll73 S 39TH ST ASSESSOR'S PARCEL NO.: 1802064108300 PROJECT DESCRIPTION: Install heat pump and air handler Springfield TYPE OF WORK: Heating System TYPE OF USE: New PhoneNumber: 541-741-7845 License Expiration Date Phone 06t27 t2007 541-726-01 00 Residential Owner: Add ress: WILLIAM KINDT I I73 S 39TH ST SPRINGFIELD OR 97478 Contractor Type Electrical Mechanical Contractor OWNER COMFORT FLOW 460 CONTRACTOR INFORMATION # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Seconda ry Construction Type: # of Bedrooms: Frontyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: NotHipfrthIl in oAResZ n Centerls 1 Type: Downspouts/Drains: ..^NUFtt- THIS PEFtrIffTs&lilAeL EXPIRE lF THE W0RK Lot Size: R-3 AUTH0RIEEBI{jt{UfmTflrc PERMIT lS NQT Sq Ft lst Floor: ,n ggr,,rM_EJ\l$ff .tttSllroND0NED FoR il [: i::.il::l; ANY 180 fl4[8,[m0D Sq Ft carage/carport Energy Path: Sq Ft Other: Sprinkled Building: nla Occupant Load: REQUIRED PARKING Total: Handicapped: Compact: tJtlltty Notes: Pase I of3 I lNruKlvlA I rut\ | Buildin g/Combination Permit Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541 -726-31 69 Inspection Line PERMIT NO: COM2006-01 153ISSUED: 0910612006APPLIED: 09/0612006 EXPIRES: 0410212007 VALUE: Valuation Descrintion Description Tvpe of Construction Fee Description -Mechanical Issuance Fee- + l0oh Administrative Fee + 57o Technology Fee + 87o State Surcharge Air Handling Unit Up to 10,000 Heat Pump Minimum/Adjustment Mechanical + l0'h Administrative Fee + 57o Technology Fee + 87o State Surcharge Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add Total Amount Paid Total Value of Project Date Paid Value Date Calculated Receipt Number 2200600000000001 241 2200600000000001 24I 2200600000000001 241 2200600000000001 241 2200600000000001 241 2200600000000001 241 2200600000000001 241 l 20060000000000 I 474 r 20060000000000 I 474 r 200600000000001474 I 20060000000000 I 474 I 20060000000000 I 474 $ Per Sq Ft or multiplier Square Footage or Bid Amount Amount Paid $10.00 s4.50 s2.25 $3.60 $8.00 $ r 2.00 s25.00 s4.90 $2.45 $3.92 $43.00 $6.00 9t6t06 9t6t06 9t6t06 9t6t06 9t6t06 9t6106 9t6t06 t0t2t06 10t2106 t0t2t06 t0t2l06 r0t2t06 $125.62 tr'ees Paid Plan Reviews To Request an inspection call the24 hour recording at 726-3769. All inspection 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. Rough Mechanical: Prior to Cover Final Mechanical: When all mechanical work is complete. Rough Electric: Prior to Cover Final Electric: When all electrical work is complete. Reouired Insnections Paee 2 of3 troffi Building/Combination Permit Status Issued 225 Fifth Street, Springfield' OR 541-726-3753 Phone 541-126-3616 Fax 541 -726-37 69 Inspection Line PERMIT NO: COM2006-01 153ISSUED: 0910612006 APPLIED: 09/0612006EXPIRES: 0410212007 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 certily that only contractors and employees who are in compliance with ORS 701.005 will be used on this project. I lurther 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. ,///.b /?./Dz /n- 2-d C Owner or Contractors Signature Date Pase 3 of3 m* Construction Contractors Board permit *: Co6ttTj5'| - O lt t 3 700 Surnrrrer St I\fE Suite 300 PO Box 14140 Salem OR 97309-5052 Phone: 503-3784621 Web Address: www.ccb.state.or.us ilt3 s 3?+t.Address: Date/e o Statement: lnformation Notice to Property Owners About Construction Responsibilities Note: Oregon Law, ORS 701.055(4) requires residential construction permit applicants who are not licensed with the Construction Contractors Board to stgn thefollowing statement before a building permit can be issued. This statement is requiredfor residential building, electrical, mechanical and plumbing permits. Ltcensed architect and engineer applicants, exemptfrom licensing under ORS 70L010(7), need not submit this statement. This statement will befiled with the permit. Fill in the appropriate blanks and initial boxes I and 2, and either box 3A or 38 l. I own, reside in, or will reside in the completed structure. 2. I understand that I must become licensed as a construction contractor if the structure is sold or offered for sale before or on completion. tr 3A. Mygeneral contractor is N*r")(ccB #) +v ry I will instruct my general conffactor that all subcontractors who work on the strrcfure must be licensed with the Construction Contractors Board. OR 38. I will be my own general contractor. 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 contract with a contractor who is licensed with the CCB and will immediately notiff 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 of this form. Lzb ,,(./uz ,/d -2-4{ (Signature ofpermit applicant) @ate) (White copy to issuing agency permitfile, pink copy to applicant.) Property_owner.doc 06-0 I -04 IssuedUy' \ ,( Actfixxg es Ytimr $wm Gsneral Contractor? &rcF*RMAYlm'\' TSTICm T# pffiffipffire,TY SWh'mR$ &BSL3T *SN$TffiUSr*Sr,' Rffi Sp*N$iBll-*YIXS NOff; Ihjs /nforma#on lrjofic* t* Pr*p*rty Own*rs a8ou{ Ccnsfrucfios ftesponsliiiiff*s il/a$ dev*lop*d &y ftro Ccnsfruc#*n Csntrarfors Soard in a*c*rdanc* with O&S f8?"0S${5J, pa**ed by ttt* f 9$9 *r*gron legis/afure. nf y*u ar* aetir:g a$ y*gr *wx *onkaef*r t* l'un"qlrucl a nerv hain* s:r rnak* a s*bst*r:ti;il irnprelv*me*l t* *x *xisting $t{ucturtr, y*xi r*}t} prav*trt many prob}ems by being nware of the f*l}*rving resp*nsibilities and cllno*xls' ffi xNxp&*y#r K*$Pclxes&htlit&*x y*x wili, ifi mt*st instances, be rutr*d t* he alr 'neffipi$y*r" a*rtr th* ecl*traet*rs you c*r:tra*t sritl: rvill be '**:np1&y*es" if, y{:}r} i.rs* **Rtrast*rs nttt trise$is*d with thc} Cqnstrrr{:ti{m C*ntraet*rs B**rd t* d* lxb*r ir: **:rstrffiet{*g *r t* assixt ir} t}tr mnstruetion *r kxprov*r**al mf a r*sidentiatr stnlc*lre. As th* e*xploy*x-, you xxrxst *omply vvitlx tte* f*li*wimgl $n"eg*mrs lryitx1bel**i{kg T'*x Larry: As an *rnptr*yer, ysu n:us{ }vithh*Id inco** tax*s fr*r:} crxpl*yee wages al the tirxx: **pkyn** *re pairt. Y*x rvill be }iabl* {*r t}:c tftx p*}'l;t*}rtr *v*n if y*u *3*n't aetxa}.ly w'it}:i:*}d t}"rs {xx {:'*:r: y*ur **ptoy***" F*r ml*r* it:*tn:::raticm, c*j! the llep*rtrnenxt *f k*vsrrue *t 503-3?$-4988. Uncr*ptrmyxr*xrt Xxeswx.xms* Txx: As al: empl*y*r, y{}u are requir*d t* pay a tax fur un*mp1$yn:*nt ir*urancc purp$$es -- *x the w*ges *f atrtr erxpl*y*es. F*r:n*:r* i**?:*matir:*, call the *r*g*r: Erurpl*3nnellt 3)epartz":r**t at 5S3-94?-X4$$. ?'tr:* {}reg** Busin*ss idmrtifrca.ti*n Nurnber (&}t:} is * **r$hine* nunh*r tbr b*t}r Oreg*n lMithhoiding and UnerypIo3m*mtIns:jrag:c**Yax.Tos1ef*rafi.{J'i,*aitr3CI3.945-809li:rrf'r:rth* appropnate foms. W*rkers, C*xmpex*s*ti*& I&suranee; As at: empl*yer, y$u are subject t<l th* Oregon Wa:rkers' Compensatic)* *-aw" and r*i"rst cbtaix w*rkers' e*rnp*xsatirn insurance for y*w empierye*s. trf y*u fail to abtain tvcrk*r$' eei*:pensation insxrance, yrl.r c*uld be suhj**t to penalties and be liabie f*r tili ctrai$! ccsts if *ne *f your employees is i*jured *:: the job. F*r r3*re inf<rrn:;:ti*n, *all tlle trY*rkers' Compensation Oivision at the llepartrnent of Consumer a*d Busi*ess Services at 503-$4?-7&X 5 " U.$, Interr*** idovemar* S*rvi*e: As :rn ernptroyer, yc>u mtrst wixl*i*ld fbderal inc*r::e tax frcm employees' wages)-* y*u wiil b* liable ltir th* t*x palx)*n{ ever'} if you did*'t a*rua}}y wit}:kold the tax. Fq:r a Fsqleratr EIN s}umb*r, caltr tire IRS at 1-8CI$-8294933 ur visit their rveb site at.w-ry1ruIg.Xgy. {}*h*r Xl.espomsibillties xxrd Arefis sf Cencerns Csde e*mplg*Ne*: &s {he p*rr:r{t h*i<tr*:r frlr this pr*j**{, },*u ere resp,r:nsib1* f*r res*lving any faitrr"r*: to m**t *o{3e r*quirernents &si rn*y be br*ughf tc y*ur attenti*n thr**gh ixsp**tions. I-,iat:ility and fr*lp*rty Flxnr*nge fnsurance: C*ntact y*rir in*urance agent t{} s*e if you ha'v'e adeqaate insurance *ou*r*g* fq:r *cr:id*nts and *missions $:ch *s filltri.ng t*ctrs, piiint *v*r spnay, w*t*r d;amag* *r:m pipe punctur*s, fir*: *r work that m*st h* r*c1*n*. Time: &{ake sur* y*u hav* s*f}icient tim* to supcrvisc your crnpl*y*es. &xp*rtls*: k{ak* sur* y*rl itav* thr ski}}s t* acl *$ your swx gel?*r*l ec*tra*t*r, tq} e**rdixate thr: rv*rk *f r*ugh-in *rrj fi*iul* trade*, *nd l* n*liiy building *trfrci*trs *s th* appr*.priate tiar"les scl th*y *an perf*nn tXre req*ired i::*pec{i*ns. trf y*r-r hav* r<iiiitigxa! qr:*sti*ns call thr {l*r:srnreti*re C*nlv**t*r* S*ard {5{}3-3?S*$S21} or iv:ril* t}r* ag*n*y at -!l{-} fi*x 1414*, $aiern, *P" $?3{}$-5t5?' Praperty_uwxcr.dcc *$-S 1 -{}4 225 Fifth Street Springfield, Oregon 97 477 541-726-3759 Phone r'! of Springfield Official Receipt ._-velopment Services Department Public Works Department RECEIPT#: 1200600000000001474 Date: 1010212006 e:44:30AM Job/Journal Number coM2006-01 153 coM2006-0lls3 coM2006-0t 153 coM2006-01 I 53 coM2006-01 I 53 Description Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add + 57o Technology Fee + 8% State Surcharge + llYo Administrative Fee Amount Due 43.00 6.00 2.45 3.92 4.90 Item Total s60.27 Payments: Type of Payment Paid By Received By Check Number Batch Number Authorization Number How Received Amount Paid CreditCard LINDA KINDT djb 002617 In Person $60.27 Payment Total: -5667 c Receint I Page I of I 1012t2006 ZON ( sPRINGFIELD *, .:r, 1 :. _.. t.ir: l,.,.ir' ;.- $,.',,,,.'.; INITIALS DATE 225 FIFTHSTREET o SPRINGFIELD,OR97477 r PH:(541)726-3753 o FAX: (541)726-3689 ELECTRI CAL PERMIT APPLICATION City Job Number 6<>G -s LOCATION OF INSTALI,ATTON: 3. COMPLETE FEE Date o.iz o 1 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 200 Amps or less 201 Amps to 400 AmPs 401 Amps to 600 AmPs 601 Amps to 1000 AmPS Over $106.00 $ 19.00 $s0.00 $ 63.00 $ 7s.00 $125.00 $163.00 $37s.00 $ 50.00 7 +\ d'/ LEGAL DESCRIPTION:to E'3oo New Residential - Single or Multi-Family per dwelling unit' 8azo6 (,( Ct A. SHALL JOB DESCRIPTION 7 Electrical Contractor Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 daYs. CONTRAC T O R IN ST ALIATTON ONTI''B. serl.ices or Feeders - Installation, Alterations or Relocation: Address City Phone N0IICE: MIT ZED UNDER OR ISA o ANY 1BO DAY P ERI 0Dr;*"ration, dteration or Relocation 200 Amps or less 201 Amps to 400 AmPs 401 Amps to 600 AmPS Supervisor License Number Constr. Contr. Number Expiration Date Signature of Supervising Electrician "B" above, Panel Iur $ 50.00 $ 69.00 $100.00 $ 43.00 $ 3.00 $ s0.00 s s0.00 $ 25.00 $ 4s.00 AI IENI .Youm the b Owners Name Address 35 L Phone q OWNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. Pump or irrigation Sign/Outline Lighting Limited Energy/Residential Limited Energy/Commercial Minimum Electric Permit Inspection Fee is $45.00 + n City ? 3728% State Surchuge l0% Administrative Fee 5% Technology Fee L|?o 60V zvu Inspection Request: 726-3769 4. TOTAL Shared Drive(T:)/Building Forms/Electrical Permit Application 8-06.doc .CITY OF OREGON o(l 3 Expiration Date l. OwnersSignature: , ' 4 ) t[ffi -+ not included) -Each Installation IS NOT ES$t., or Feeders tollow rul* &,|11**&HllFlfir** Status Issued 225 Fifth Street, Springfield' OR 541-726-3753 Phone 541-726-3676 Fax 541-7 26-37 69 Inspection Line Building/Combination Permit PERMIT NO: COM2006-01 153ISSUED: 0910612006 APPLIED: 09/0612006 EXPIRES: 03/0612007 VALUE: SITE ADDRESS: 1173 S 39TH ST ASSESSOR'SPARCELNO.: 1802064108300 PROJECT DESCRIPTION: Install heat pump and air handler Springfield TYPE OF WORK: Heating System TYPE OF USE: New PhoneNumber: 541-741-7845 Contractor Type Mechanical Contractor COMFORT FLOW Expiration Date 06t27t2007 Residential Phone 541-726-0100 Owner: Add ress: WILLIAM KINDT II73 S 39TH ST SPRINGFIELD OR 97478 License 460 # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: Frontyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: Notes: R-3 VN # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: Yo of Lot Coverage: Lot Size: Sq Ft lst Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: . REQUIRED PARKING Total: Handicapped: Compact: nla Sidewalk Type: Downspouts/Drains: $ Per Sq Ft or multiplier Square Footage or Bid Amount PUBLIC IMPROVEMENTS Description Type of Construction Pase I of2 Value Date Calculated e DrrvL,LUrM.LN r INISJ Valuation Description I Status Issued 225 Fifth Street, Springfield' OR 541-726-3753 Phone 541-726-3676 Fax 541 -7 26-37 69 I nspection Line Building/C ombination Permit PERMIT NO: COM2006-01 153ISSUED: 0910612006APPLIED: 09/0612006 EXPIRES: 03/0612007 VALUE: Fee Description -Mechanical Issuance Fee- + l0oh Administrative Fee + 57o Technology Fee + 80 State Surcharge Air Handling Unit Up to 10,000 Heat Pump Minimum/Adjustment Mechanical Total Amount Paid Amount Paid Total Value of Project Date Paid Receipt Number 2200600000000001241 2200600000000001 241 2200600000000001 241 2200600000000001241 2200600000000001 241 2200600000000001 241 2200600000000001 241 $r0.00 $4.50 $2.25 $3.60 $8.00 $12.00 $25.00 9t6t06 9t6t06 9t6t06 916106 9t6/06 9t6t06 9t6t06 $6s.3s ews To Request an inspection call the24 hour recording at 726-3769, All inspection 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. Rough Mechanical: Prior to Cover Final Mechanical: When all mechanical work is complete. Reouired Insnect 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.k tb,lb^? /a /oQ - 0wner,'or Contractors Signature Pase 2 of 2 Date r ees raro 225 Fifth Street Springfield, Oregon 97 477 541-726-3759 Phone C' of Springfield Official ReceiPt L elopment Services DePartment Public Works DePartment RECEIPT #: 220060000000000r24r Date: 0910612006 ll:57:03AM Job/Journal Number coM2006-01153 coM2006-01 153 coM2006-01 153 coM2006-01153 coM2006-01 153 coM2006-01153 coM2006-01153 Description + 5%o Technology Fee + 8% State Surcharge + 10o/o Administrative Fee Air Handling Unit Up to 10,000 Heat Pump M inimum/Adjustment Mechanical -Mechanical Issuance Fee- Amount Due 2.25 3.60 4.50 8.00 12.00 25.00 10.00 Item Total:s65.J5 Payments: Type of Payment Received By Check Number Batch Number Authorization Number How Received Amount PaidPaid By COMFORT FLOW HEATING, co. ddk 35465 In Person $6s.35Check Payment Total:$65.3s cReceinl I Page I of I 9t6t2006 liF**ilAFtfl.ll