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Home My WebLink AboutPermit Mechanical 2020-01-16on€G0N Web Address : www.springfield-or.9ov Building Permit Residential Mechanical Permit Number: 81 1-2O-OOO1O7-MECH IVR Number: 81 1031920334 City of Springfield Development and Public Works 225 Fifth Street Springfield, OR 97477 541-726-3753 Email Address : permitcenter(q.\springfield-or. gov SPRIN6FIELD ,s Permit Issuedi January L6, 2020 OF Category of Construction: Single Family Dwelling Submitted Job Value: $0.00 Description of Work: New wood stove installation in garage Type of Work: Replacement Worksite Address 301 S 57TH ST Springfield, OR 97478 Parcel 170233440 1 000 Owner: Address: GARRY DEGULIS 2017 REVOCABLE TRUST PO BOX 1640 LINDENHURST, NY 11757 LICENSED INFORTTIATION Business Name OWNER - Primary License CCB License Number 000000 Phone PET{DING INSPECTIONS Inspection 2999 Final Mechanical 2300 Rough Mechanical Inspection Group Mech Res Mech Res Inspection Status Pending Pending Various inspections are minimally required on each prolect 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: 811031920334 Schedule using the Oregon ePermitting Inspection App, search "epermitting" in the app store Permits expire if work ls not started within l8O Days of lssuance or lf work is suspended for l8O Days or longer dependlng on the issuing agency's pollcy. All provlsions of laws and ordinances governing this type of work will be complied with whother specified herein or not, Granting of a Permit docs not presumc to give authority to violate or cancel the provisions of rny other state or local law regulating construction or the performance of construction. ATTENTIOT{: Oregon law requires you to follow rules adopt€d by the Oregon Utility Notification Center. Those rules are iet forth in OAR 952'OO1-O010 through OAR 952-001-OO90, You m.y obtain coplGs of the rules by calllng the Center at (5O3) 232-t947. All persons or entities performing work under this permit are requircd to b€ licensed unless exempted by ORS 701,O10 (Structural/Mechanical), ORS 479.540 (Electrical), tnd ORS 693.O10-020 (Plumbing). pnnted oni 1/16/20 page I of 2 C:\myReports/reports//production/01 STANDARD JOB SITE INTORMATION SCHEDULING INSPECTIONS Permit Number: 81 f -20-OOO107-MECtl Page 2 of 2 Fee Descrlptaon Technology Fee Balance of minimum permit fees - mechanrcal Wood/pellet stove State of Oregon Surcharge - Mech (L2o/o of applicable fees) Pflnted on: 1/16120 Quantity Fee Amount $5. 10 $48.00 $ 54.00 $t2.24 $119.34Total Fees: C r \myReports/repods//productron/0 1 STANOARD 1 Page 2 of 2 PERMIT FEES SPRINGTIELD ORTGON www.springfi eld-or. gov Worksite address: 301 S 57TH ST, Springfield, OR 97478 Parcel:1702334401000 Transaction Receipt 811-20-000107-MECH IVR Number: 81 1031920334 Receipt Number: 473568 Receipt Date:1116120 City of Springfield Development and Public Works 225 Fifth Street Springfield, OR 97477 541-726-3753 permitcenter@springfield-or. gov Transaction Units date 1116120 1.00 Ea 1t16120 1.00 Automatic 1t16t20 1.00 Ea 1t16t20 Descriptlon Wood/pellet stove Balance of minimum permit fees - mechanical State of Oregon Surcharge - Mech (12o/o ol applicable fees) Fees Paid Account code 1.00 Automatic Technology Fee 224 -00000-425604- 1 03 1 224-00000-425604- 1 03'1 B2 1 -00000-21 5004-0000 204-00000425605-0000 Fee amount $54.00 $48.00 $12.24 s5.1 0 Pald amount $54.00 $48.00 $12.24 $5.10 Payment Method: Credit card authoiization: 02735c Payer: GARRY DEGULIS Payment Amount:$119.34 20.17 REVOCABLE TRUST Cashier: Katrina Anderson Rocolpt Total:$'r'r9.34 Printed. 1/16/20 11 27 am Page 1 of 1 $s*.. -d ,& F IN_TransactionReceipt-Jrr Crry or SpmNGFrELu, Ontrcox Mechanical Permit A lication 225 Fifth Street o Springfield, OR 97477 . PH(54t)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. h, c i-l CATEGORY OF CONSTRUCTION ,Etesidential I Government E Commercial JOB SITE INFORMATION AND LOCATION Job site address State:arc, q7q7i R"f"rir(..' -J Taxlot. pESCRTPTTON 9F WOBK OR'1 ,.,r.^. PROPERTY OWNER Name: Address: State:nP:?77{ Phone Fax: E-mail This me or a member of my immediate licensing requirements oRS 701.01 66rrxA TION Business name:V Address City:*State:ZIP: Phone:Fax: E-mail: l) CCR license no. Print narne Signature: FEE SCHEDULE Residential Qty.Cost ea. Total cost First Aooliance i102.00 $ Furnace/burner including ducts and vents Up to l00k BTU/hr.$23.00 s Over l00k BTUlhr $26.00 $ Heaters/stoves/vents Unit heater $23.00 $ Wood/pellet/gas stove/fl ue t $54.00 $fu Evaporated coolcr $19.00 ( Vent fan with one duct/appliance $r3.00 $ Hood with exhaust and duct $19.00 $ Gas pinins One to four outlets $9.00 $ Additional outlets (each)$s.00 $ Air-handline units, includins duc s Up to 10,000 CFM $15.00 S Over 10,000 CFM $26.00 $ Comnressor/absorotion svstem/heat numn Up to 3 hp/I00k BTU $23.00 s Up to l5 hp/500k BTU $41.00 $ Up to 30 hp/I,000 BTU $61.00 S Up to 50 hp/1,750 BTU $78.00 $ Over 50 hp/I,750 BTU $132.00 $ 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 ea. Total cost Reinspection 8102.00 $ Specially requested inspections (per r02.00 s Rcgulated cquipmcnt (unclassed);19.00 $ Each additional inspection: (l)iI02.00 s DEPARTMENT USE (A) Enter subtotal ofabove fees (or enter set minimum fee of $ 102.00)s 102- (B) Investigative fee $ (C) Enter 12%o surcharge (.12 x [A+B])$ (D) Seismic fee, lVo (.01 x [A])$ (E) Technology Fee (5% of [A-l)$ TOTAL fees and surcharges (A through E):$ rtQ,39 DEPARTMENT USE ONLY Permit no.:-@ Last edited 7/li20l9 BJones 7zr \=?Pf Date:r irt" \>- Propefi 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 (2ll 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 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 lwill 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 tnformation Notice to Homeowners About Construction Responsibilities, and I hereby certify that the information on this homeowner statement is true and accurate. Print Name of Applicant of,Date Permit #: Address 'x\1 Lr)\-, Datelssued 5 ?14" SX r-f This CoPY for Permit Offlces N lnformation Notice to Owners About Construction ResPonsi bi I ities (oRS 701.325 (3)) CONSTRUCTION CONTRACTORS BOARD PO Box 14140, Salem, OR 97309-5052 Telephone: 503-3784621 - Fax: 505373-2007 Website Address: www. oregon. oovlccb./--^^^+, ^..,nar :innfo.1 A_)O16 Homeowners acting as their own general contractors to construct a or make a substantial improvement to in existing structure, can prevent by biing aware of the following responsibilities: Homeowners who use labor provided by workers not licensed by the Construction Contractors Board, may be considered an employer, ano 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 th-e time employ""r-rr" paid. You will be liable for the tax payments even if you don't actually *itnnoU the tax fiom 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 wtniotoing 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 th" job. For more information, call the Workers Compensation Division it tne Departmeni of Consumer and Business Services at 800-452-0288' Tax Withholding: Employers must withhold social security Tax and Federal lncome Tax from "rproy"" *.g"J. 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' new home many problems a a a o a a Other Responsibilities of HomeowRers : 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. propefi 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 lnsurance. 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. o a o Th's Copy for Permit