The URL can be used to link to this page

Home My WebLink AboutPermit Mechanical 2003-10-01Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676Fax 541-726-37 69 Inspection Line Building/Combination Permit PERMIT NO: COM2003-00864ISSUED: 1010112003APPLIED: 09/0812003 EXPIRESz 0410112004 VALUE: SITE ADDRESS: 1868 YENTA AVE ASSESSOR'SPARCELNO.: 1703243401000 PROJECT DESCRIPTION: Gas furnace & heat pump OWNCT: GINGERY FAMILY TRUST Address: 1868 YENTA AVE SPRINGFIELD OR 97477 Springfield TYPE OF WORI(: Heating System TYPE OF USE: Addition Residential Contractor Type Electrical Mechanical Contractor License OWNER ASSOCIATED HEATING & AIR CONDITIO 106275 Expiration Date Phone 08t3u2004 s41-683-2s90 CONTRACTOR INFORMATION # of Buildings: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: SETBACKS Frontyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: #of \s Dist: # Street Trees Rqd: Paved Drive Rqd: oh of Lot Coverage: I Lot Size: Sq Ft lst Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Impervious Surface Area: REQUIRED PARI(NG Total: Handicapped: Compact: IRE IT lHElCE: PER M\T SH ALL EXP MllS PER V{ORK IS NOl ANY 1 Downspouts/Drains: Notes: Pase I of3 r t$s OR \S BO Building/Combination Permit Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676Fax 541-7 26-37 69 Inspection Line PERMIT NO: COM2003-00864ISSUED: 10/01/2003APPLIED: 09/0812003 EXPIRESz 0410112004 VALUE: Description Tvpe of Construction Fee Description -Mechanical Issuance Fee- + l0Yo Administrative Fee + 77o State Surcharge Furnace - up to 100,000 btu Gas Outlets l-4 Heat Pump Minimum/Adjustment Mechanical + l0oh Administrative Fee + 77o State Surcharge Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add Total Amount Paid Total Yalue of Project Date Paid Value Date Calculated Receipt Number 1200200000000002080 1200200000000002080 1200200000000002080 1200200000000002080 1200200000000002080 1200200000000002080 1200200000000002080 1200200000000002247 1200200000000002247 1200200000000002247 1200200000000002247 $ Per Sq Ft or multiplier Square Footage or Bid Amount Amount Paid $10.00 $4.50 $3.15 $12.00 $4.00 $12.00 $17.00 $4.60 $3.22 $43.00 $3.00 $116.47 9t8t03 9t8t03 9t8t03 9t8t03 9t8t03 9t8t03 9t8t03 10/1/03 t0nt03 10/1/03 10/1/03 Feps Pa' 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. I Rough Mechanical: Prior to Cover 2 Final Mechanical: When all mechanical work is complete. 3 Rough Gas: After line is installed and required testing and capped if not attached to an appliance. 4 Gas Service: After line is installed and line has been connected to a minimum of one appliance including required testing. Presure test done at this point. 5 Final Gas: When all gas work is complete. 6 Rough Electric: Prior to Cover 7 Final Electric: When all electrical work is complete. Rpnuirpd fnsnecfions Paee 2 of 3 Valuation Descrintion FIELD Building/Combination Permit Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676Fax 541-7 26-37 69 Inspection Line PERMIT NO: COM2003-00864ISSUED: 1010112003APPLIED: 09/0812003EXPIRESz 0410112004 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 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. ., -/:o 3 Owner or Date Page 3 of3 I 225 FIFTH STREET . SPRINGFIELD, OR97477 o PH:(541)726-3 ?SleJ$g5gq84qy?l6sj689itted has the rollowins Zbning, and doesnot require specific land use E LECTRI CAL P ERMIT AP P LI CATI O N CityJobNumber LaqZooj -OO%:l Date ,/a I 8LK LEGAL l^ ^'32'i 3i o tooo approval. -/- O 9 Zonins Each Manufact'd Home or Modular Dwelling Service or Feeder JOB DESCzuPTION 3. P[1 \o A. Nerv Rcsidcntinl - Singlc or tUulti-Farnilv per duclling unit. Service Included 1000 sq. ft. or less Each additional 500 sq. ft. or portion thereof s 106.00 $ 19.00()z Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. 2. O0NTRACTOR INSTALIATION ONLr B. Electrical Contractor Address Phone Supervisor License Number s50.00 $ 63.00 $ 75.00 $125.00 $ 163.00 $375.00 $ 50.00 50.00 City 200 Amps or less 201 Amps to 400 Amps 401 Amps to 600 Amps 601 Amps to 1000 Amps Over 1000 Amps/Volts Reconnect Only Expiration Date orJ Constr. Contr. Number Expiration Date Signature of Supervising Electrician above. 69.00 $100.00 $ 43.00 $ 3.00 New Alteration or Extension Per Panel One Circuit Each Additional Circuit or with Service or Feeder Permit Ll3 (7Oumers Name Address ciW-S,. r'g Phonel:r- OWNER INSTALLATION ,k' tiorrE. \S The installation is being made on property I own which is not intended for sale, lease or rent. EB 1H\S .00 50.00 s 25.00 $ 45.00 Permit Inspection Fee is $45.00 * Surcharges 1 4.VL 7Yo State Surcharge l0% Administrative Fee TOTAL 3ZL ,1bo o15J'!Inspection Request: 726-3j 69 Shared Drive(T:)/Building Fonns/Electrical permit Application l -03.doc Tm C.,rk bJN- the ot the 7it z"z. l: Construction Contractors Board 700 Summer St NE Suite 300 PO Box 14140 Salem OR 97309-5052 Phone: 503-378-4621 Web Address: www.ccb.state.or.us Permit #: Cfu"azco .o€6v keAddress: Issued by:)(Date: lO *a/ -OS Statement: lnformation Notice to Property Owners About Gonstruction Responsibilities Note: Oregon Law, ORS 701.055(4) 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. This statement is requiredfor residential building, electrical, mechanical and plumbing permits. Licensed architect and engineer applicants, exemptfrom licensing under ORS 701.010(7), need not submit this statement. This statement will befiled with the permit. Fill in the appropriate blanks and initial boxes I and2, and either box 3A or 38: ff t. I own, reside in, or will reside in the completed structure. S Z. I understand that I must become licensed as a construction conhactor if the structure is sold or offered for sale before or on completion. 3,A.. My general contractor is (Name)(ccB #) I will instruct my general conhactor that all subcontactors who work on the strtrcture must be licensed with the Constnrction Contractors Board. OR fr'r, 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 nrrme of the contractor. I hereby certify that the above information is correct and that I have read and do understand the Information Notice to Owners about Construction Responsibilities on the reverse side of this form. /o-/-a3 applicant)(Date) (White copy to issuing agency peftnilfile, pink copy to applicant.) Property_owner.doc 03/ I I /03 Acting as Your Own General Contractor? INFORMATION NOTICE TO PROPERTY OWNERS ABOUT CONSTRUGTION RESPONSIBILITIES NOIE: This lnfarmation Notice to Property Owners about Constructrbn Responsibilities was developed by the Construction Confracfors Board in accordance with ORS 7U.A55(5J, passed by the 1989 Oregan Lagislature. If you are acting as your own contractor to constnrct a new home or make a substantial improvement to an existing structure, you can prevent many problems by being aware of the foliowing responsibilities and concerns. Employer Responsibilities You will, in most instances, be ruled to be an 'uemployer" and the contractors you contract with wilt be "employees" if you use contractors not licensed with the Conshuction Contractors Board to do labor in constructing or to assist in the construction or improvement of a residential structure. As the employer, you mlrst comllly wlth the following: Oregonos lVithholding Tax Law: As an omployer, you mu$t withhold income taxes from ernployee 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 a State Business II) number, call the Business Infonnation Center at 503'986-2200. Unemployment Insurance Tax: As an employer, you are required to pay a tax for unemployment insurance purposcs,. onthewagesofa11emp1oyees.Formoreinformation,calltheoregonEmploymerrtDepartrherrtit503.947-1488..<,. Workers' Compensation Insurance: As an employer, you are subject to the Oregon Workers' Compensation Laq, and must obtain workers' compensation insurance for your employees. If you fail to obtain workers' compensation insurance, you could be subject to penaities and be liable for all claim costs if one of your employees is injured on the job. For more information, call the Workers' Compensation Division at the Deparknent of Consumer and Business Services at 503-947-7815. U.S. Internal Revenue Service: As an employer, you must withhold federal income tax from employees' wages. You will be liable for the tax payment even if you didn't actually withhold the tax. For a Federal EIN number, call the IRS at 866-816-2065 or fax them at 801-620-7115. Other Responsibilities and Areas of Concerns Code Compliance: As the permit holder for this project, you are responsible for resolving any failure to meet code requirements that may be brought to your attention through inspections. Liability and Property Damage fnsurance: Contact your insurance agent to see if you have adequate insurance coverage for accidents and omissions such as falling tools, paint over spray, water damage from pipe puncttnes, fire or work that must be redone. Time: Make sure you have sufficient time to supervise your ernployees. Expertise: Make sure you have the skilis to act as your owrl general contractor, to coordinate the work of rough-in and finish trades, and to notifr building officials as the appropriate times so they can perform the required inspections. If you have additional questions call the Construction Contractors Board (503-3?84621) or write the agency at PO Box 14140, Salem, OR 97309-5052. Prope4y_owner.doc 03/1 ll03 225 Fifth Street Springfield, Oregon 97 477 541-726-3759 Phone City of Springfield Official Receipt Development Services Department Public Works Department Receipt #z 1200200000000002247 Date: 1010112003 1:59:07PM coM2003-00864 coM2003-00864 coM2003-00864 coM2003-00864 Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add + 7Yo State Surcharge + llYo Administrative Fee 43.00 3.00 3.22 4.60 Item Total:$s3.82 Type ofPayment Paid By Received By Batch Number Authorization Number How Received Amount Paid Cash Change LARRY GINGERY LARRY GINGERY djb djb In Person In Person Payment Total: s55.00 ($ 1.1 8) $s3.82 coM2003-00864 coM2003-00864 coM2003-00864 coM2003-00864 Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add + 7%o State Surcharge + llYo Administrative Fee 43.00 3.00 3.22 4.60 Item Total:$s3.82 Payments: Type ofPayment Paid By Received By Batch Number Authorization Number How Received Amount Paid Cash Change LARRY GINGERY LARRY GINGERY djb djb In Person In Person Payment Total: $55.00 ($ 1.1 8) $s3.82 Status: Issued 225 Fifth Street, Springfield, OR 541:726-3753 Phone 54l-726-3676Rax 541 :7 26a7 69 I ns pe ction Line Buildin g/Co mbination Permit PERMIT NO: COM2003-00864ISSUED: 09/08/2003APPLIED: 09/0812003E)GIRES: 03/0812004 YALUE: SITE ADDRESS: 1868 YENTA AVE ASSESSOR'S PARCEL NO.: 1703243401000 PROJECT DESCRIPTION: Gas furnace & heat pump Owner: 6INGERy FAMILy TRUST Address: 1868 YENTA AVE SPRINGFBLD OR 97477 Springfield TYPE OF TYPEOF USE: Single Family Residence Addition Residential Contractor Type Mechanical Contractor License ASSOCIATED HEATING & AIR CONDITION1O6275 Expiration Date 08t3u2004 Phone 541-683-2590 CONTRACTOR INFORMATION BUILDING INFORMATION # of Buildings: Primary Occupancy Group: Secondary Occupancy Primary Construction Type Secondary Construction # of Bedrooms: SETBACKS Frontyard Setbaclc Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: # of Stories: Height of Type of Heat: Water Type: Range Type: Energy Path: Overlay Dist: # Street Trees Paved Drive Rqd: %o ofLot Coverage: MIl IS NI Lot Size: Sq Ft lst Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Impervious Surface Area: REQUIRED PARI(NG Total: Handicapped: Compact: ATTENTION:Oregon law requires you to Notification Center. Those rules are set irrQ$fiffA$l -001 0 through OAR 9s2-00 1 S PER D FOR 0Q9^Q-Ypl,mpy-p&[ain copies of the rulesuorvnsDouts/urams-derfiiff$ ili6-cb7rl-er. (Note: the te|ephoneNDONE $ Per Sq Ft or muhiplier Square Footage or Bid Amount number for the Oregon Utility Notification Center is 1 -800-332-2344\. Total Value of Project lof2 DEVELOPMENT INFORMATION Valuation Descrintion Description Type of Construction Value Date Calculated r\t- Building/C ombination Permit Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676Ftx 541 -7 26-37 69 Inspection Line PERMIT NO: COM2003-00864ISSUED: 09/08/2003APPLIED: 09/0812003EXPIRES: 03/0812004 VALUE: Description Tvpe of Construction Fee Description -Mechanical Issuance Fee- + l0%o Administrative Fee + 7oh State Surcharge Furnace - up to 100,000 btu Gas Outlets 1-4 Heat Pump Minimum/Adj ustment Mechanical Total Amount Paid Total Value of Project Date Paid Value Date Calculated Receipt Number 1200200000000002080 1200200000000002080 1200200000000002080 1200200000000002080 r200200000000002080 1200200000000002080 1200200000000002080 $ Per Sq Ft or multiplier Square Footage or Bid Amount Amount Paid $10.00 $4.50 $3.1s $12.00 $4.00 $12.00 $17.00 9t8t03 9/8/03 9t8t03 9/8/03 918t03 9t8t03 9t8t03 $62.6s ['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. I Rough Mechanical: Prior to Cover 2 Final Mechanical: When all mechanical work is complete. 3 Rough Gas: After line is installed and required testing and capped if not attached to an appliance. 4 Gas Service: After line is installed and line has been connected to a minimum of one appliance including required testing. Presure test done at this point. 5 Final Gas: When all gas work is complete. Rparrirpd Insneefinns Page 2 of 3 T Valuation Descrintion I FIELD Building/C ombination Permit Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676Fax 541-7 26-37 69 Inspection Line PERMIT NO: COM2003-00864ISSUED: 09/08/2003APPLIED: 09/0812003EXPIRES: 03/0812004 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 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. Owner or Contractors Signature Date Page 3 of3 225 Fifth Street Springfield, Oregon 97 477 541-726-3759 Phone coM2003-00864 coM2003-00864 coM2003-00864 coM2003-00864 coM2003-00864 coM2003-00864 coM2003-00864 City of Springfield Official Receipt Development Services Department Public Works Department Receipt #: 1200200000000002080 Datr: 09/0811003 12,18:20PM Furnace - up to 100,000 btu Gas Outlets 14 Heat Pump -Mechanical Issuance Fee- Minimum/Adj ustment Mechanical + lYo State Surcharge + l0Yo Administrative Fee 12.00 4.00 12.00 10.00 17.00 3.15 4.50 Item Total:$62.65 Type of Payment Paid By Received By Batch Number Authorization Number lfow Received Amount Paid Check ASSOCIATED HEATING dlm 10697 In Person Payment Total: $62.65 $62.65