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Home My WebLink AboutPermit Mechanical 2003-06-04Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676Fax 541-7 26-37 69 Inspection Line Building/Combination Permit PERMIT NO: COM2003-00452ISSUED: 0610412003APPLIEDz 0610412003 EXPIRESz 1210412003 VALUE: SITE ADDRESS: 241415TH ST ASSESSOR'S PARCEL NO.: 1703243300400 PROJECT DESCRIPTION: Install furnace and AC Springfield TYPE OF WORK: Heating System TYPE OF USE: New Residential Owner: Address: BENTIEN JERRY WAYNE 2414N15THST SPRINGFIELD OR 97477 Contractor Type Mechanical Owner Contractor BEYMERHEATING & SHEET METAL CO BENTIEN JERRY WA)'NE License 4483 Expiration Date tut4t2004 Phone 541-688-5004 CONTRACTOR INFORMATION # of Buildings: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: SETBACKS # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: %o ofLot Coverage: Lot Size: Sq Ft lst Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Impervious Surface Area: R-3 VN Frontyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: Notes: ( Type: Square Footage REQUIRED PARKING Total: Handicapped: Compact: s TION Description Type of Construction $ Per Sq Ft Page I of2 Value Date Calculated r{sFrSLD t3- cJr-$'".$t"-{e.@ n$l \\ $* $s s'.st $\o Valuation Description I OF Building/C ombination Permit PERMIT NO: COM2003-00452ISSUED: 0610412003APPLIED: 0610412003EXPIRES: 1210412003 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-7 26-37 69 Inspection Line Fee Description -Mechanical Issuance Fee- + l0o Administrative Fee + 7oh State Surcharge Air Handling Unit Up to 10,000 Appliance Vent Furnace - up to 100,000 btu Gas Outlets 1-4 Minimum/Adj ustment Mechanical Total Amount Paid Amount Paid Total Value of Project Date Paid 6t4t03 614103 614103 6t4t03 6t4t03 6t4t03 6t4t03 6t4t03 Receipt Number 1200200000000001434 1200200000000001434 1200200000000001434 1200200000000001434 120020000000000r434 1200200000000001434 120020000000000r434 120020000000000r434 $10.00 $4.s0 $3.1s $8.00 $6.00 $12.00 $4.00 $1s.00 $62.65 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. 1 Rough Gas: After line is installed and required testing and capped if not attached to an appliance. 2 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. 3 Rough Mechanical: Prior to Cover 4 Final Gas: When all gas work is complete. 5 Final Mechanical: When all mechanical work is complete. 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 s Owner or Contractors Signature Pase2 of2 Date Kequrreo tnspeellolls l 225 Fifth Street Springfield, Oregon 97 477 541-726-3759 Phone City of Springfield Development Services Department Public Works Department Official Receipt Receipt #: 12002000000000 01434 Date: 0610412003 coM2003-00452 coM2003-00452 coM2003-00452 coM2003-00452 coM2003-00452 coM2003-00452 coM2003-00452 coM2003-00452 Furnace - up to 100,000 btu Air Handling Unit Up to 10,000 Gas Outlets l-4 Appliance Vent Minimum/Adjustment Mechanical -Mechanical Issuance Fee- + 7Yo State Surcharge + l0o/o Administrative Fee Payments: 12.00 8.00 4.00 6.00 15.00 10.00 3. l5 4.50 Item Total:$62.65 Check BEYMER HEATING djb In Person Payment Total: 62.65 $62.6s 6/4/2003 I l:09:55AM Page I of I cReceipt.rpt ( ( t\726-3689225 FIFTH STREET . SPRINGFIELD, OR97477 o PH:(541)726-3753 o FAX: E LE CTRI CAL P E RMIT AP P LI CATI ON ciryJobNumber (A41Z:E\3* OOL|SL out" o60603 I LACAT'ION OF IN ST'ALI-ATION Lq/q /sTl( -rr I-EGAL DESCRIPTION l?o 3 zLl 33 OOr{oO JOB DESCRIPTION ZoNn9A. New Residential - Service IncludePu\" 1000 sq. ft. or les.hu" g\goatu(e Each additional500 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 1000 Amps/Volts Reconnect Only D. Branclr Circuits New Alteration or Extension Per Panel One Circuit Pump or irrigation Sign/Outline Lighting Limited Energy/Residential Lim ited Energv/Con.rmercial 4.s CIFAnA\rE 7o/o State Surcharge l0% Administrative Fee TOTAL 3.BELO ,P $ 106.00 $ 19.00 $ 63.00 $ 7s.00 $ r 25.00 $ 163.00 $37s.00 $ s0.00 50.00 69.00 100.00 unit. \o(\zeo City &s f-Ar',*<L + (cuitr 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. }2NTRACTOR TNSTALLATTON ONLY Electrical Contractor Address Phone a 0, Supervisor License Number .Jf Expiration Date li Constr. Contr. Number Expiration Date Signature of Supervising Electrician OWNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: $s0.00 B. Services or Feeders - Installation, Alterations or Relocation: Each Additional Circuit or with / Service or Feeder Permit L{3 $ 43.00 $ 3.00 Owners Name t€ Ae'/ Qe"k*,at) Address LV tq lsTll ff E. I,Iiscellarteous (Sen'ice/feeder rtot irrcluded) -Each Installation City fPktv Ih€t-O vt',on" lf$(,f!LL $ s0.00 $ 50.00 $ 25.00 $ 4s.00 fr 3n*-Tv Inspection Request: 726-37 69 Shared Drive{T:)/Building Fonns/Electrical Permit Applicalion l -03.doc F?IEFCT\!.t CITY OF fiE NCg9 i{,tI1 CE: I llto AUT C. Temporary Services or ANY Amps * Surcharges ,/ L 3ZL . u60-f sftr- Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676Fax 541-7 26-37 69 Inspection Line Building/Combination Permit PERMIT NO: COM2003-00452ISSUED: 0610412003APPLIED: 0610412003EXPIRES: 1210612003 VALUE: SITE ADDRESS: 2414 15TH ST ASSESSOR'S PARCELNO.: 1703243300400 PROJECT DESCRIPTION: Install furnace and AC Owner: BENTIEN JERRy WAyNE Address: 2414 N 15TH ST SPRINGFIELD OR 97477 Contractor Type Electrical Mechanical Owner Springfield TYPE OF WORK: Heating System TYPE OF USE: New Residential Contractor License OWNER BEYMER HEATING & SHEET METAL CO 4483 BENTIEN JERRY WAYNE Expiration Date Phone tut4t2004 541-688-5004 CONTRACTOR INFORMATION G 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 Rearyard Solar Street Improvements: Storm Sewer Available: Special Instruction: # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Path: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: Yo ofLot Coverage: Lot Size: Sq Ft lst Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Impervious Surface Area: R-3 VN ( REQUIRED PARJ(NG Total: Handicapped: Compact: Sidewalk Type: DownspoutslDrains: Notes: Page I of3 L \\w- r*s 1\ Buildin g/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: COM2003-00452ISSUED: 0610412003APPLIEDz 0610412003 EXPIRESz 1210612003 VALUE: Description Tvpe of Construction $ Per Sq Ft Amount Paid Fee Description -Mechanical Issuance Fee- + lOoh Administrative Fee + 77o State Surcharge Air Handling Unit Up to 10,000 Appliance Vent Furnace - up to 100,000 btu Gas Outlets 1-4 Minimum/Adj ustment Mechanical + l0oh Administrative Fee + 7oh State Surcharge Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add Total Amount Paid $116.47 Total Value of Project Date Paid Square Footage Value Date Calculated Receipt Number 1200200000000001434 1200200000000001434 1200200000000001434 1200200000000001434 1200200000000001434 1200200000000001434 1200200000000001434 1200200000000001434 1200200000000001458 12002000000000014s8 1200200000000001458 r2002000000000014s8 $10.00 $4.s0 $3.15 $8.00 $6.00 $12.00 $4.00 $1s.00 $4.60 $3.22 $43.00 $3.00 6t4t03 6t4t03 614t03 6t4t03 6t4t03 6t4t03 6t4t03 6t4t03 6t6t03 6t6t03 616t03 6t6t03 ['ees Pe] 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. 1 Rough Gas: After line is installed and required testing and capped if not attached to an appliance. 2 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. 3 Rough Mechanical: Prior to Cover 4 Final Gas: When all gas work is complete. 5 Final Mechanical: When all mechanical work is complete. 6 Rough Electric: Prior to Cover 7 Final Electric: When all electrical work is complete. Renrrirpd Insneefions Paee 2 of3 Valuation Descriotion I 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: COM2003-00452ISSUED: 0610412003 APPLIEDT 0610412003EXPIRESt 1210612003 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 of 3 []- 225 Fifth Street Springfield, Oregon 97 477 541-726-3759 Phone City of Springfield Development Services Department Public Works Department Official Receipt Receipt #: 1200200000000001458 Date:06/06/2003 Joh/JoumrlNunb.I D.rcdpdon coM2003-00452 coM2003-00452 coM2003-004s2 coM2003-00452 Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add + 7%o Stzte Surcharge + l0o/o Administrative Fee 43.00 3.00 3.22 4.60 Item Total:$s3.82 Payments Cash Change JERRY BENTIEN JERRY BENTIEN b b dj dj In Person In Person Payment Total: 55.00 ( l.l8) $s3.82 coM2003-00452 coM2003-004s2 coM2003-00452 coM2003-00452 Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add + 1oh State Surcharge + ljYo Administrative Fee Payments: 43.00 3.00 3.22 4.60 Item Total: -$ffiCash Change JERRY BENTIEN JERRY BENTIEN djb djb In Person In Person Payment Total: 55.00 ( 1.18) $s3.82 616/2003 8:46:02AM Page I of I cReceipt.rpt *ffi*&