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Home My WebLink AboutPermit Mechanical 2004-10-14Status 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: COM2004-01272ISSUED: 1011412004 APPLIEDz 1011412004 EXPIRESz 0411412005 VALUE: SITE ADDRESS: 683 32ND ST ASSESSOR'S PARCEL NO.: 1702312101900 PROJECT DESCRIPTION: Add furnace and ac Owner: ECKERSONJOHN C Address: 683 32ND ST SPRINGFIELD OR 974 Springfield TYPE OF WORK: Heating System TYPE OF USE: New Residential s4t.r2frl6Hevt ..e1 o 19Contractor Type Electrical Mechanical # of Units: 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: Notes: License Expiration Date Phone Lot Size: Sq Ft lst Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load:nla of Structure Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: Yo oflot Coverage: Type: Downspouts/Drains: PARJ(NG $ Per Sq Ft or multiplier Square Footage or Bid AmountDescription Type of Construction Page 1 of3 Value Date Calculated rll r.\' ll\rl.rruYlAll(rl\ Valuation Description I Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676Fax 541-7 26-37 69 Inspection Line FIELD Building/Combination Permit PERMIT NO: COM2004-01272ISSUED: 1011412004 APPLIED:. 1011412004 EXPIRESz 0411412005 VALUE: Fees Paid Amount Paid Total Value of Project Date Paid Fee Description -Mechanical Issuance Fee- + l0oh Administrative Fee + 77o State Surcharge Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add Air Handling Unit Up to 10,000 Appliance Vent Furnace - up to 100,000 btu Gas Outlets 1-4 Minimum/Adjustment Mechanical Total Amount Paid $10.00 $9.10 $6.37 $43.00 $3.00 $8.00 $6.00 $12.00 $4.00 $15.00 t0n4t04 r0n4t04 t0n4t04 t0n4l04 t0n4t04 t0n4t04 t0n4t04 t0n4t04 t0fi4104 t0n4t04 Receipt Number 1200400000000001476 1200400000000001476 1200400000000001476 1200400000000001476 120040000000000r476 1200400000000001476 r200400000000001476 1200400000000001476 120040000000000r476 120040000000000r476 $1r6.47 Plan Reviews To Request an inspection call the 24 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. 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. Rough Electric: Prior to Cover Final Electric: When all electrical work is complete. Renrrired fnsneetions Paee 2 of 3 ::T F 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: COM2004-01272ISSUED: 10114t2004APPLIED: 10fl4t2004EXPIRESz 04fi4t2005 VALUE: By signature,I state and agree, that I have carefully examined the completed application and do hereby certify that allinformationhereon is true and correct, and I further certify that any and all work performed shall be done in accordance withthe Ordinances of the City of Springfield and the Laws of the State of Oregon pertaining to the work described herein, andthat NO OCCUPAIICY 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 req uested at the proper time, that each address is readable from thestreet, that the permit card is located at the front ofthe property, and the approved set of plans will remain on the site at alltimesconstruction. 4 Owner or Contractors Signature Date /, Paee 3 of3 225 FIFTH STREET . SPRINGFIELD, OF.97477 o PH:(541)726'3753 o FA)ft (541)726-3689 E LE CTRI CAL P ERMIT AP P I'I CATT ON City Job Number Ca*t orzlz 1.3I rb<3 3a^)SI LEGAL DESCRIPTION t7023 tzl Ol 7 OC servicelncluded JOB DESCRJPTION 1000 sq. ft. or less Each additional 500 sq. ft. or portion thereof Each Manufact'd Home or Modular Dwelling Service or Feeder A C-< O-.<-"ri I S 2. B. law req Electrical Contractor lollow rules ad d the OrogAhbEddyess on ose rulegg4rg5pl t64h amps Address in OAR 952-001-0010 through Qdtll$'ffi fiftbo a-pt Supervisor License Number A. $paril(lFtELD $l .00>}z City Permits are non-transferable and erpire if work is i not started within 180 days of issuance or if work is Suspended for 180 daYs. Expiration Date Constr. Cont. Number Expiration Date Signanre of Supervising Electrician s 75.00 s125.00 $r63.00 $375.00 $ 50.00 Installation, Alteration or Relocation 200 Amps or less $ 50'00 201 Amps to 400 AmPs S 69'00 401 Amps to 600 AmPs $100'00 Over 600 or 1000 Volts see "B" above. Each Additional Circuit or with Service or Feeder Permit $ 3.00 3 c. D. New Alteration or Extension Per Panel i t / "? NSTICE: I Owlers Name Address t,/Cr kn H+S PERMIT *3 3, City Phone OWNERINSTALLATION The installation is being made on propefty I own which is not intended for sale, lease or rent. DAY FOR Limited Energy/Residential $ 25'00 Limited Energy/Commercial $ 45'00 Minimum Electric Permit Inspection Fee is $45.00 * surcharges \.lL $ 50.00 $ 50.00 ?3?77% State Surcharge l0% Administrative Fee TOTAL q60 S,3Inspection Request 726-37 69 4. Shared Drive(T:YBuilding FormVElectrical Permit Application t -03.doc EZ Amps 0 Center is 1 Eort*AJ) -4 Construction Contractors Board 700 Summer St IrlE Suite 300 PO Box 14140 Salem OR 97309-5052 Phone: 503-3754621 Web Address: www.ccb.state.or.us Permit #: Co w o<t- OtL-7L Address: bg 3 3?'*J S Issued by:\6 Date 1o.o statement: rnformation Notice to property ownersAbout construction Responsibirities Note: oregon Law' oRS 701'055(4) requires residential construction permit applicants who are notlicensed with the constructton contractors Boatrcl to sign thefoilowing statement before a buildingpermit can be issued' This statement is re-quiredfor reiidential building, electrical, mechanicar andplumbing permits' Licensed architect ,"d;;gi;;;, applicants, exemptfrom licensing underoRS 701'010(7), need not submit this statemZnt. rhiiitatement wrtinepua with the permit. Fill in the appropriate branks and initiar boxes r and2,and either box 34 or 38: q 1. I own, reside in, or will reside in the completed structure. ry 2' lyO"T:-o that I must become licensed as a construction contractor if the structure is sold oroffered for sale before or on completion. tr 3A. My general contractor is (Name)(ccB #) I will insbrrct my general confractor that all subcontractors who work on the sbucture must beIicensed with the Construction Conhactors Board. OR X 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 fnformation Notice to Property Owners about Construction Responsibilities on the reverse side of this form. c-/q- (Signature of permit applicant) @ate) (White copy to issuing agency pennilfile, pink copy to applicant.) Property-owner.doc 06-0 1 -04 Acting as Your own General contractor? INFORMATION NOTICE TO PROPERTY OWNERS aaiiurconsrnucTtoNRESPONSIBILITIE8, existing If you are structure, E mPloYer ResPo nsibilities :, o ^^a..racrn* vou contf&ct with will be "qmployees" if il:#t*fr:::*:Ti,"":"::s*:i:".*;ffi-i:q;ffi$",:rff:T-.:"'ffi:ilo,*,**iuepr'[?assii'lia'ltreconstruction*iorpr#*""toroi"la*u'ifi;il:;-tt;t;;l'';;voumus!complvwithth*uo'u*:t., oregon,s \trithholding Tax 1T,1: I 3ruJoVer, you must withhold incomti fiies &om employbe wages at the time employees are paid. -?o, *il be rable ila" tu*-p*y**,rtc "; if you don.!31tuauy withhold the 11x *orn your employees- For more i"fo*tio"; call the"bep*il& of R*"*u" at 503-3784988' unemployment Insurance Tax: As an employer, you a1: r.eeyred to pay a tax for unemployment {yryrce purposes'- on the wage$ of ar1 ernployees. For *or. ir,?orroriion, catt ,r; or"g"" ilmptoyment Department at 503-94?-1488' \- The oregon Business ldentification Nurnber (BIN) is 1 -clmbinod nrgyrber for both oregon withholding and" unernployrnert rnsrrance iax.::o nr* #" grN, "it so:-qas-i'9r or \'ww-dor.state.or.us/fonrrspay'html1 for the appropriate forms' '' workers, compensation Insurance: As an emproyer, you are subject to,the ol:Fo" workers' compsnsation Law' and must obtain workers, compensation insuranc" io, yor, .*!i;;;;;. If you fail"to obtain workers' compansation insurance, you courd be subject to penalties';;; riuui* r* "ri.i"'i*.ort1irry of yo,r employees is injt*ed on the job. For more inform;;;;call &e wo.*rr; compensation oi*"ior, at the Depa*ment of cornsumer and Business Services at 503-947-7815 ' u.s. rnternar Revenue service: As an employer, you must.withhold federal incorne tax from ernpluyees'l*hgeg")-- you will be liable for ths rax paymen, *""liy"i, diin't actuatty *rtr,r,ora the tax. For a Federal EIN nurnber' call the ns u, 1_g00-g2g4gr3 or;uit tiretr weu gite ar wvrAlr.irg"qov . ! '""' other Responsibilities and Areas of concerns code compliance; As the permit hoider for this project, you are responsible for resolving any failure to meet code ,"qrir"*"r"tis that may be brought to your atlention through it'lspections' Li*bility antl propertl. Damage Ins{rance: cOntact your insurance agdnt to see if you have adequale insurance cov€rage for ac*irienrs ,,:n3 omisiions sueh as falling tootrs, paint over spray. water dantage {iom pipe prrncrures' fire or work that mrist bc r'rdutl'; Time: hdake sure you hate sufficient time to supervise your emploj€€&:.r. rti;',rr' 'E iilii i' Ji;,-i.'ifli'i'- ' Expertise: Make sure you'have'tHe.mrii to i.t as'v6iribwn'general contractoi,'to cooddlrtlie the work of rough-in und tinirt trades, and t6-notif, building officials as the appropriate times so they can perform the required inspections' If you have additionatr questions cail the Construction Contractors Board (503-3784621) or write the agency at PO Box 14140, Salem, OR 9?309-5052. 1{ .,t....r:.! .r. .r!{,ir Property_owner.doc 06-0 1 -04 thebywasdevelopedResponsibiliflesConstructionaboutOwnersfolVoficePropertYlnformationIhls989Legistature.I OregontheNATE:by055{5)701 passedORSwithaccordanceinBoardContractorsConstruction you can Prevent manY Probiems to construci a new home or by being aware'of the following responsibilities and concems' 225 Fifth Street Springfield, Oregon 97 477 541-726-3759 Phone rrty of Springfield Official Receipt ,velopment Services Department Public Works Department RECEIPT #: 1200400000000001476 Date: 1011412004 1:52:o1PM Job/Journal Number coM2004-01272 coM2004-01272 coM2004-01272 coM2004-01272 coM2004-01272 coM2004-01272 coM2004-0r272 coM2004-01272 coM2004-0t272 coM2004-0t272 Description Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add Fumace - up to 100,000 btu Air Handling Unit Up to 10,000 Appliance Vent Gas Outlets l-4 Minimum/Adjustment Mechanical -Mechanical Issuance Fee- + 7Yo State Surcharge + l0% Administrative Fee Amount Due 43.00 3.00 12.00 8.00 6.00 4.00 15.00 10.00 6.37 9. l0 Item Total:$116.47 Payments: Type of Payment Paid By Received By Batch Number Number How Received Amount Paid Check Number Authorization Check JOHN ECKERSON djb 680 In Person Payment Total: $ l 16.47 - $116.47 t01t412004 Page I of I