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Home My WebLink AboutPermit Mechanical 2005-07-27CITY OF Building/Combination Permit Status: Issued 225 Fifth Street, Springfield, OR 541:726-3753 Phone 541-726-3676Fax 541:7 26-37 69 Inspe ction Line PERMIT NO: COM2005-01005ISSUED: 0712712005 APPLIEDT 0712712005 E)(PIREST 0112712006 VALUE: SITE ADDRESS: 231 18TH ST ASSESSOR'S PARCEL NO.: 1703363100700 PROJECT DESCRIPTION: Install heat pump and air handler Springfield TYPE OF TYPEOF USE: Heating System New Residential Owner: Address: Contractor Type Mechanical ERIN SIVIITH 231 18TH ST SPRINGFIELD OR 97477 Contractor MARSHALLS INC )regon t opted b License 25790 Igon oAR 952-001' Sq Ft Garage/Carport Sq Ft Other: n/a Occupant Load: ES Sidewalk Type: DownspoutVDrains Phone Number: 541- Date Phone 541-747-7445 REQUIRED PARJ(NG Total: Handicapped: Compact: # of Uni6: Primary Occupancy Group: Secondary Occupancy Piimary Constructlon Type Secondary Construction # of Bedrooms: . Front5nrd Setbaclc Side l Setback: Side 2 Setback: Rearyard Setback: Solar Setbacls: Street Storm SewerAvailable: Special Instruction: Notes: R-3 YN Range Type: Energy Path: Sprinkbd Overlay Dist: # Street Trees Paved Drive Rqd: o/o ofl,ot Coverage: $ Per Sq Ft or muhiplier Square Footage or BII Amount CONTRACTOR INFORMATION )RMATION Descriptbn Type of Construction lof2 Value Date Calculated --:r.} I tHE V Valuation Descriotion I GFIELD Building/Combin ation Permit Status: Issued 225 Fifth Street, Springfield' OR 541:726-3753 Phone 541-72G3676Fax 541:7 2G37 69 Inspe ction Line PERIVIIT NO: COM2005-01005ISSUED: 0712712005 APPLIEDz 0712712005E)?IRES: 0112712006 VALUE: Fee Description -Mechanical Issuance Fee- + l0%o Administrative Fee + 1oh State Surcharge Air Handling Unit Up to 10,000 Heat Pump Minimum/Adj ustment Mechanical Total Amount Amount Paid $10.00 $4.50 $3.15 $8.00 $12.00 $2s.00 $62.6s Total Value of Project Date Paid 7t27t05 7t27tus 7t27t05 7t27t05 7t27t05 7t27105 Receipt Number 1200500000000001092 1200500000000001092 1200500000000001092 1200500000000001092 1200500000000001092 1200500000000001092 aid Plan Reviews To Request an inspection call the24 hour recording at 72G3769. 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. By signaturer l state and agree, flrat I have carefully examined the completed application and do hereby certify that all information hereon is true and correct, and I further certify ttrat any and all work performed shall be done in accrdance with the Ordinances of the City of SpringfieH and the Laws of the StaG of Oregon pertaining to the work described herein, and that NO OCCUPAI\CY will be made of any structure without permission of the Community Services Division, Building Safety. I further certiS 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 the permit card is located at the front of the property, and the approved set of plans will remain on the site du Reouired Insnections at or Contractors Signature 2of2 Date 1-z? - of h 225 Fifth Street Spdngfield, Oregon 97 477 541-726-3759 Phone City of Springfield Official Receipt :velopment Services Department Public Works Department RECEIPT#: 1200500000000001092 Date: 0712712005 2:03:51PM Job/Journal Number coM2005-0100s coM2005-0100s coM2005-01005 coM2005-01005 coM2005-01005 coM2005-0r00s Description + 7Yo State Surcharge + l0% Administrative Fee Air Handling Unit Up to 10,000 Heat Pump Minimum/Adjustment Mechanical -Mechanical Issuance Fee- Amount Due 3.15 4.50 8.00 12.00 25.00 10.00 Item Total:$62.65 Payments: Tlpe of Payment Paid By CheckNumber Auttorization Received By Batch Number Number How Received Amount Paid Check MARSHALLS INC djb I 8733 In Person $62.65 Payment totat: --56ffi 7/27/200s lofl rmerta.D g prulcL.r as suomtlteo nas the following does 'YUilSYric rand useroning, and 22S FIFTH STREET o SPRINGFIELD, OF.g7477 o PH:(541)726-3753 o FAX: (541)72'6'3\689 ELECTRICAL PERMIT APPLICATTON City Job Number ?5b ')toog Date LEGALDESCzuPTION C tobl 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 B. Services or Feeders - Installation, Alterations or Relocation: slrlc {no-?w ,,',tr(nrn t. tOCirrcN OFINS?HI LAI'ION 3. COMPLETE IIEE SCHEDLTLE BELOW New Residential - Single or Nlulti-Family per drvelling unit. \ IF 200 Amps or less 201 Amps to 400 Amps 401 Amps to 600 Amps 601 Amps to 1000 Amps Over 1000 AmpsA/olts Reconnect Only One€ftU,ltg the center. (ir,;: r acfl Kr{l&i6Jer diloJ}rcr sith. Service or f fcflAgetmlt- dr, ;i -.; $106.00 $ 19.00 $s0.00 $ 63.00 $ 7s.00 $ 125.00 $ 163.00 s375.00 $ 50.00 Ciry Contractor Address Phone Supervisor License Expiration Date Constr. Contr. Number Expiration Date Signature of Supervising Electrician C. Temporary Services or Feetlers Installation, Alteration or Relocation 200 Amps or less $ s0.00 $ 69.00201 401 s100.00 above. D. New Alteration or Extension Per Panel I $ 43.00 $ 3.00 oo 3.OO Owners Name E.Address City Phone OWNER INSTALLATION The installation is being made on properfy I own which is not intended for sale, lease or rent. Owners Signature: Pump or irrigation $ 50.00 Sigrr/Outline Lighting $ 50.00 Limited Energy/Residential $ 25.00 Limited Energy/Commercial $ 45.00 Minimum Electric Permit Inspection Fee is $45.00 * Surcharges 4. SWTOTAL OFABOW TohStzte Surcharge l0% Administrative Fee TOTAL c$tL Ll Inspection Request: 726-3769 Shared Drive(T:)/Building Forms/Electrical Permit Application l-03.doc to 400 rules S JOB DESCRIPTION . \' - Permits are non-transferable and expire if work is '" not started within 180 days of issuance or if work is Suspended for 180 daYs. , CONTRACTARINSTALLATIONONLYL. a2 l) (_I 4t" oo tr7L4 t"o 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: COM2005-01005ISSUED: 0712712005APPLIEDz 0712712005EXPIRESz 0210112006 VALUE: F SITE ADDRESS: 231 18TH ST ASSESSOR'S PARCEL NO.: 1703363100700 PROJECT DESCRIPTION: Install heat pump and air handler Springfield TYPE OF WORJft Heating System TYPE OF USE: New Residential Owner: Address: Contractor Type Electrical Mechanical ERIN SMITH 231 18TH ST SPRINGFIELD OR 97477 Contractor OWNER MARSHALLS INC License 25790 IL PhoneNumber: 541-988-4255 Expiration Date Phone 12t23t2005 541-747-7445 BUILD # 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: # ofStories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: Lot Size: Sq Ft lst Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: R-3 VN nla gon d by the Notification Center. Those ru 3:BT"d1HH$[1ARKrNG Overlay Distin OAR 952_001-C010 through 0[ftd52-001- # street TretlBgd: You may obtain copies ofEradidds$: iil',l', ff ,Il$# ;:,'l::,i-J 3i; J I; [i LU ffi ffi,h Center is 1 -800-332 -2344). Sidewalk Type: Downspouts/Drains: Notes: Pase 1 of3 L Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676Eax 541-7 26-37 69 Inspection Line Building/Combination Permit PERMIT NO: COM2005-01005ISSUED: 0712712005APPLIEDz 071271200s EXPIRESz 0210112006 VALUE: Description Type of Construction Fee Description -Mechanical Issuance Fee- + l0o/o Administrative Fee + 7o/o State Surcharge Air Handling Unit Up to 10,000 Heat Pump Minimum/Adjustment Mechanical + l0o/o Administrative Fee + 77o State Surcharge Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add Total Amount Paid Total Value of Project Date Paid 7t27t05 7t27tgs 7t27t05 7t27t05 7l27t0s 7t27t0s 8/1/05 8/1/05 8/U0s 8/1/0s Value Date Calculated Receipt Number 1200500000000001092 1200s00000000001092 r200500000000001092 1200500000000001092 1200500000000001092 1200s00000000001092 2200500000000001015 2200500000000001015 2200s0000000000r01s 2200500000000001015 $ Per Sq Ft or multiplier Square Footage or Bid Amount Amount Paid $10.00 $4.s0 $3.1s $8.00 $12.00 $25.00 $4.60 $3.22 $43.00 $3.00 $116.47 ['ees 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. 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. red Insnpcfinns Page 2 of3 Valuation Description 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: COM2005-01005ISSUED: 0712712005APPLIEDz 0712712005EXPIRES: 0210112006 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 70f .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 Pase 3 of3 Construction Contractors Board Pennit #:'1-JO -oto6 Address:25l \8+h t*r<*l- Issued by:Date:8 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 thefollowing 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 and 2, and either box 3A or 38: ,K , 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. 3A. My general contractor is (Name)(ccB #) I will instrrct my general contactor that all subcontractors who work on the stnrcture 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. 700 Summer St IYE Suite 300 PO Box 14140 Salem OR 97309-5052 Phone: 503-3784621 Web Address: !EE.cc$!4t9"ry N qltlo{ (Sign-ature of permit applicant) (White copy to issuing agency pennitfile, pink copy to applicant.) r @ate) Property_owner. doc 06-0 I -04 Acting as Your Orvn General Contractor? INFORMATIOH NOTICE TO PROPERW OWNERS AEOUT CANSTRUCTTON RESPONS|B|LrIES I If you are aciing as your own conkactor to construct a new home or make a substantial improvement to an existing strucfure, you can prevent manyirtfilems by beirig aware of the following responsibilities and concerns. Employer Responsibilities You.-will, in most insiances, be ruled to be an "employer" and the contractors you contract with will be "employees" if you u$f confractors not licensed with the Construction Contractors Board to do labor in constructing or to assist in the constuction or improvement of a residential structure. As the erhployer, you must comply with the follo'wing: Oregon's \[ithholding Tax Law: As an employer, you must withhold income taxes from employee wages at the time employees are paid. You will be liable for the tax paymerts even if you don't actually withhold the tax from your employees. For more information, call the Department of Revenue at 503'378-4988. Un*mployment Insurance Tax: As an employer, you are required to pay a tax for unernployment insurance purpostip.. on the wages of ali emplcyees. For more information, call the Oregon Employment Departmentat 5*3-947-1488. The Oregon Business ldentification Number (BII'{) is a combined nurnber for. both Oregon Withholding and-' UnemploymentInsuranceTax.TofileforaBIN,ca1l503-945-8091orforthe appropriate forms. : IVorkers' Compensation Insurance: As an employer, you are subject to the Oregon Workers' Compensation Law, and must obtain workers' comperuation insurance for your employees. If you fail to obtain workers' compensation insurance, you could be subject to penalties and be liable for all claim costs if one ofyour employees is injured on the job. For more information, call the Workers' Compensation Division at the Departmenl'of Consumer and Business Services at 503 -947 -7 81 5. U.S. Internal Revenue $ervice: As an employer, you must withhold federal income tax from enrployees'w&ges.'r You will be liable for the tax palment even if you didn't actually withhold the tax. For a Federal EIN number, call rhe' IRS at 1-800-8294933 or visit their web site &t 111g{.lrC.ggy ,, . ,; . Other Responsibilities.ond Areas of Concerns i 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.'':ri:'.-t"" .:llij Linbility and Property Iiarnagri irrrurrn*r, Contact your insurance agsnt to see if you have adequate'itrsuritnisr' coverage lbr accidents and omissions such as lalling tools, paint over spray, water damage from pipe punctures, fire or work that must be redone. .- .- -_-j ,- .. -i-_ Time: Make sure ycu hrVe sufficient time to supervise your employees- Expertise: Make sure yr:u have ttie ifdni to act is 1}bu. o*rii'g"neral contractor, to cooidiiate the work of rough-in and finish kades, and to nalify building officials as the appropriate tirnes so they can perfbrm the required inspections. If you have additronal qucstions call the Construction Contractors Board (503-378-4621) or write the agency at PO Box 14140, Salem, OR 97309-5052. .: . :.j .. .;:::..,., Property owner.doc 06-0 1-04 NOTE: Tltis lnformation Natice ta Property Awners about Construction Responsibitities n/as developed by the Construction Contractors Board in accordance with ARS 701.055(5J, passed by the 1989 Oregon Legistature. 225 Fifth Street Springfield, Oregon 97 477 541-726-3759 Phone City of Springfield Official Receipt rvelopment Services Department Public Works Department RECEIPT #: 2200500000000001015 Date:08/01/2005 10:15:43AM Job/Journal Number coM2005-0100s coM2005-0100s coM2005-0100s coM2005-01005 Description Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add + 7Yo State Surcharge + l0% Administrative Fee Amount Due 43.00 3.00 3.22 4.60 Item Total:$53.82 Payments: Type of Payment Paid By Check Number Received By Batch Number Authorization Number How Received Amount Paid Check ERIN SMITH ddk 622 In Person Payment Total: $53.82 -sffi 8/t/2005 Page I of I $pn}raliFr&l.tl