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Home My WebLink AboutPermit Mechanical 2020-01-29OREGON Web Address: www.springfi eld-or.9ov Building Permit Residential ilechanical Permit Number: 81 1-2O-OOO178-MECH IVR Number: 811080325241 City of Springfield Development and Public Works 225 Fifth Street Springfield, OR 97477 54t-726-3753 Email Address: permitcenter@springfield-or.gov SPRINGFIELD $ Permit Issued: January 29,2020 TYPE OF WORK Category of Construction: Single Family Dwelling Submitted Job Value: $0.00 Description of Work: Replacing water heater Type of Work: Replacement JOB SITE INFORTTIATION Worksite Address 2797 3RD ST Springfield, OR 97477 Parcel 1703233405000 Owner: Address: ROTH JEFFREY ] & STACY P 87310 CEDAR FLAT RD SPRINGFIELD, OR 97478 LICE NSED 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 Inspection 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. Schedule or track inspections at www.buildingpermits.oregon.gov Call or text the word "schedule" to 1-888-299-2821 use IVR number: 811080325241 Schedule using the Oregon ePermitting Inspection App, search "epermitting" in the app store Permlts expire if work is not started within 18O 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. ATTENTIONT 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 (structuraUltechanical), oR.s 479.54o (Electrical), and ORS 693.o1o-o2o (Plumbing). pdnted oil Ll29l2O page I of 2 C:\myReports/reports//production/01 STANDARD I Permit Number: 81 1-2O-OOO178-MECH Page 2 of 2 Fee Description Technology Fee Balance of minimum permit fees - mechanical Water heater State of Oregon Surcharge - Mech (L2o/o of applicable fees) Printed aN 1/29/20 Quantity Fee Amount $ s.10 $83.00 $ 19.00 $12.24 $ 119.34Total Fees: C :\myReports/rercrts//prcduction/01 STAN DARD 1 Page 2 of 2 PERMIT FEES SPRINGFIELD # OREGON www. springf ield-or.gov Worksite address: 2797 3RD ST, Springfield , OR 97477 Parcel: 1703233405000 Transaction Receipt 811-20400178-MECH IVR Number: 81 1 080325241 Receipt Number:473663 Receipt Date:1129120 City of Springfield Development and Public Works 225 Fifth Street Springfield, OR 97477 541-726-3753 perm itcenter@spri n gfiel d-or. gov Transaction Units date 1129120 1.00 Ea '129t20 '1 .00 Automatic 1t29t20 1.00 Ea 1t29t20 Description Water heater Balance of minimum permit fees - mechanical State of Oregon Surcharge - Mech (12o/o ol applicable fees) 224 -OO000 -425604-'l 03 1 224-00000 - 425604- 1 03 1 821 -00000-21 5004-0000 20 4 -000 00 - 4256 0 5-00001.00 Automatic Technology Fee Fees Paid Account code Fee amount $19.00 $83.00 $12.24 $5.1 0 Paid amount $19.00 $83.00 $12.24 $5.10 Payment Method Credit card authorization: 03483c Payer: ROTH JEFFREY J & STACY P Payment Amount: Cashier: Katrina Anderson Receipt Total:$r 19.34 Ptinled: 1129120 9:32 am Page 1 of 1 Fl N_TransactionReceipt_pr $1 19.34 Crry or SrnrNGFIELo, ORtrcoN Mechanical Permit A lication SPBIilGFIgLO *, Ecll 225 Fifth Street o Springfield,OR97477 . PH(541)726-3753 . FAX(541)726-3689 This permit is issued under OAR 918-440-0050. Permits expire if work is not started within 180 days of issuance or if work is suspended for 180 days. FEE SCHEDULE Residential Qty.Cost ea. Total cost First Aooliance i102.00 s Furnace/burner including ducts and vents Up to l00k BTU/hr s23.00 $ Over 100k BTU,&r $26.00 $ If eef ers/stoves/vents Unit heater I $23.00 SZ' Wood/pellet/gas stove/fl ue $54.00 $ Evaporated coolcr $19.00 $ Vent fan with one ducVappliance $13.00 $ Hood with exhaust and duct $19.00 $ One to four outlets $9.00 $ Additional outlets (each)$s.00 $ Up to 10,000 CFM $15.00 $ Over 10,000 CFM i26.00 $ Comnressoriabsorption svstem/heat nump Up to 3 hp/100k BTU i23.00 $ Up to 15 hp/500k BTU i41.00 $ Up to 30 hp/I,000 BTU 16r.00 $ Up to 50 hp/1,750 BTU $78.00 $ Over 50 hp/I,750 BTU 8132.00 $ Incinerators Domestic incinerator 826.00 $ Commercial Enter total valuation ofmechanical system and installation costs $ _ Enter fee based on valuation ofmechanical system. etc.$ Miscellaneous fees Cost ea. Total cost Reinspection u02.00 $ Specially requested inspections (per 1102.00 $ Regulated equipment (unclassed)ll 9.00 $ Each additional inspection: (l)t102.00 $ DEPARTMENT USE (A) Enter subtotal ofabove fees (or enter set minimum fee of $ 102.00)S IOL (B) Investigative fee $ (C) Enter l2olo surcharge (.12 x [A+B])$ (D) Seismic fee, lVio (.01 x [A])$ (E) Technology Fee (5% of [Al)$ TOTAL fees and surcharges (A through E):$ tr1.3 i DEPARTMENT USE ONLY Permit no.oo\?rc - Date:M >.) CATEGORY OF CONSTRUCTION frlResidential ! Government E Commercial JOB SITE INFORMATION AND LOCATION Job site address:pffi] ZP' t;7 city: *f FO Slate: (\/nqTz+-77 Reference Taxlot. DESCRIPTION OF WORK A l)r> n-t n-(a- PROPERTY OWNER Name: J'911f '?Cr:l-l Address: A'7q'7 4r\+ '11 State:pQ nq74flCity: - ,: Z{ fD Phon$l-H bqTb Fax E-mail: ^tI;€FZ6*i - €_{* (Z)tvl( ktrf , l<A This installation is being member of my immediate R ormemade licensing Signature: Irequirements Bus'iness name: Address City:Y State ZIP Phone:Fax: E-mail: Print name Signature: Lasr edited 7lll20l9 Blones Air-handlins units. includinp duc s CCB license no.: 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 7o1.325 (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 structure 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 lnformation Notice to Homeowners About Construction Responsibilities, and I hereby certify that the information on this homeowner statement is true and accurate. aE#|ZCv,tZon4 Print Name of Permit APPlicant Permit #:%-o@t7r9'vl zch Address:2Yqh b 4 lssued by Date r(la\:-o This Copy for Permit Offices 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: 503-378-4621 - Fax: 50$373-2007 Website Address: www.oregon.gov/ccb a Homeowners acting as their own general contractorc 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 empioyees. As an employer, you must comply with the following: Oregon,s Withholding Tax Law: Employers must withhold income taxes from employee wages at thL 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 bn the wages of all employees. For more information, call the Oregon Employment Department at 503-947 -1 488. Oregon,s Business tdentification Number (BlN): is a combined number for both Oregon With-holding 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 it tne Department of Consumer and Business Services at 800*452-0288. Tax Withholding: Employers must withhold Social Security Tax and Federal lncome Tax from employee *"geJ. 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'trs.oov. a a O a a a Other Responsibilities of Homeowners: Code Compliance: As the permit holderfor 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 therr own contractors should coniact [heir insurance agent to ensure adequate insurance coverage for accidents and omissions, such as falling tools, paini 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. a o f/nrnnor*rr nwnar :dnnfed g-7O1 5 This Copy for Permit