The URL can be used to link to this page

Home My WebLink AboutPermit Mechanical 2003-05-21Building/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: COM2003-00391ISSUED: 0512112003APPLIEDz 0512112003 EXPIRESz 1112312003 VALUE: SITE ADDRESS: 2437 34TH ST Springfield TYPE OF WORK: Heating System ASSESSOR'S PARCELNO.: 1702193101114 TYPE OF USE: New Residential PROJECT DESCRIPTION: Install heat pump, air handler and duct work Owner: MATTIIEWS CORy J & SHERI A Address: 2437 34TII ST SPRINGFIELD OR 97477 Contractor Type Electrical Mechanical Owner Contractor OWNER COMFORT FLOW MATTHEWS CORY J & SHERI A License Expiration Date Phone 06t27t2003 541-726-0t00460 BUILDING INF # of Buildings: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: Street Improvements: Storm Sewer Available: Special Instruction: # of Stories: Height of Structure of Heat: \)\ Dist: Trees Rqd: Paved Drive Rqd: o/o of Lot 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 09 61 {$e REQUIRED PARKING Total: Handicapped: Compact: \S t0s PUBLIC IMPROVEMENTS Notes: Pase I of3 LL'I\II\I(-,I(IYIAITl'I\ I ts Frontyard Side 1 Side 2 Setback:r$ Rearyard Solar Setbacks: 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: COM2003-00391ISSUED: 0512112003 APPLTED-. 05t2u2003 EXPIRESz 1112312003 VALUE: Description Tvpe of Construction $ Per Sq Ft Total Value of Project Date Paid Value Date Calculated Receipt Number 1200200000000001276 1200200000000001276 1200200000000001276 1200200000000001276 1200200000000001276 1200200000000001276 1200200000000001312 1200200000000001312 r200200000000001312 1200200000000001312 Square Footage 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 + l$oh Administrative Fee + 1oh Sttte Surcharge Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add Total Amount Paid Amount Paid $10.00 $4.50 $3.1s $8.00 $r2.00 $2s.00 $4.60 $3.22 $43.00 $3.00 $116.47 5t2u03 5t2u03 5tzu03 5tzu03 5t2u03 5t2u03 5t23t03 5t23t03 5t23t03 st23t03 Epps Pqid 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 Mechanical: Prior to Cover 2 Final Mechanical: When all mechanical work is complete. 3 Rough Electrig: Prior to Cover 4 Final Electric: When all electrical work is complete. Reouired fnsnections Paee 2 of3 i Valuation Descrintion I Building/C ombination Permit Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676Fax 541-726-37 69 Inspection Line PERMIT NO: COM2003-00391ISSUED: 0512112003APPLIED: 0512112003 EXPIREST 1112312003 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 Page3 of3 225 FIFTH STREET . SPRINGFIELD, OR97477 o PH:(541)726-3753 o FAX: (541)726-3689 E LE CT RT CAL P E RM IT AP P LI CA TON Ciry Job Number Cet4 co3 ? / our.'Z o I. LOCAT'IONOP'INSTEU-A?'ION J CAMPLETE B'EE SCIIEDUI,b }JELOI4r zL|3-7 3rll\ sr# A.New Residential - Single or Multi-Family per drvelling unit.LEGAL DESCRIPTIONTCZt?3( o(tr1 Z. COnII:I?ACrOR INSIi{II-qTION ONLI- B. Services or Feetlers - Installation, Alterations or Relocatiort: .IOB DESCRIPTION Alb Z c-( €.e.. T a Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 da1's. Electrical Contractor Address Expiration Date Signature of Supervising Electrician Owners Name Address 2131 3f u^ Ciry Sn"f\.I vhone Jtg-']tr77\' OWNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. Owners Or,er 600 Amps or 1000 Volts see "B" above. llranch ('ircuits New Alteration or One Circuit Each 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 200 Amps or less 201 Amps to 400 Amps 401 Amps to 600 Amps \t1 Lighting Limited Energy/Residential Limited Energy/Commercial 7o/o State Surcharge l0% Administrative Fee TOTAL s 106.00 $ 19.00 $50.00 $ 63.00 x $ 7s.00 sl2s.00 $ 163.00 $375.00 $ 50.00 $ 50.00 $ 69.00 s 100.00 $ 43.00 $ 3.00 $ 50.00 $ s0.00 $ 2s.00 included) -Each lnstalla tion 601 Amps to 1000 AmPs City _=-- Phon" __.- Over 1000 Amps/Volts Reconnect OnlY Superr,'isor License Number 1n C' Temporaqy Serriices or Feetlers .r-j' Expiratio, Date Ov" Installation, Alteration or Relocation 200 Arnps or less Constr. Contr. Number - 201 Amps to 400 Amps 401 Amps to 600 AmPs D. t{3 $r_l_3 $ 4s.00 Minimum Electric Permit Inspection Fee is $45.00 * Surcharges 4. SLTBTOTAL OF ABOW YT 5zL q60 SIEZInspection Request: 726-37 69 Shared Dlive(T:)/Building Forrns/Electrical Pennit Application l -03.doc CITY OF OKEGON I Construction Contractors Board 700 Summer St NE Suite 300 PO Box 14140 Salem OR 97309-5052 Phone: 503-378-4621 WebAddress:ry!.g!g!44 Permit *: C-1trZoc.i - &3? I Address: z431 3y*L + Issued by:\6 Date: OSZ3 03 ^h 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 and2, and either box 3A or 38: )( f . 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 (Narne)(ccB #) I will instrrct my general contractor that all subcontractors who work on the structure must be licensed with the Constnrction Contractors Board. OR 38. I will be myown ge,neral 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 notifo 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. 5-23'd3 of permit applicant)(Date) (llhite copy to issuing agency permitfile, pink copy to applicant.) Property_owner.doc 03/ I I /03 ,x Acting as Your Own General Contractor? INFORMATION NOTICE TO PROPERTY OWNER$ ABOUT CONSTRUCTION RESPON$IBILITIES I'IOIE; This lnformaflon Notrce ta Property Ourners aboul Construction ffesponsibllifr'es was deve/op ed by the Construction Contractars Eoard in accordaace with ORS 7U.A55(5), passed by the 19Bg Oregon Legislature. trf you are acting as your own oontractor to construct a new home or make a substantial improvement to an existing skucture, you can prevent many problems by being aware of the follcwing responsibilities and concerns. Employer Responsibilities You will, in most instances, be ruled to be an "employer" and the conffactors you contract with will be "employees" if you use contractors not licensed \vith the Construction Contractors tsoard to do ]abor rn oonstructing or to assist in the construction or improvement of a residential strueture. As the employer, you must comply with the following: Oregon's Withholding Tax Law: As an employer, you must withhold income taxes from employee u/ages at the time employees are paid. You u,ill be liable for the tax payments ever if you don't actually withhold the tax from your employees. For a State Business II) number, call the Business Information Center at 503-986-2200. Unemployment Insurance Tax: As an employer, you are required to pay a tax for unemployment insurance purposes on the wages of all employees. For more inforrnation, call the Oregon Employment Department af 503-947-1488. : Workers' Compensation Insurance: As an employer, you are subject to the Oregon Workers' Compensation Law, and must obtain ,*-orkers' compensation insurance for your emplnyees. If ycu fail to obtaitr workers' cgmpensation insurance, you could be subject to penalties and be liable for all claim costs if one of your employees is injured on thejob. For more information, call the Workers' Compensation Division at the Departrnent of Consumer and Business Services at 503-947-78 i5. 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, eall 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 pmject, you are responsible for resolving any failure to meet code requirements that may be brought to your attentior through inspections. tiability 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 punctures, fire or work that must be redone. Time: Make sure you have sufficient time to supervise your employees. ,. Expertise; Make sure you have the skills to act as your own generai conffactor, to coordinate the work of rough-in and finish trades, and to notiff building oflicials as the appropriate times so they can perform the required inspections. If you hav'e additional questions call the Construction Contractors Board (503-3?84621) or write the agency at PO Box 14140, Salem,0R 97309-5052. Property_owner"doc 03ll I 103 225 Fifth Street Springfield, Oregon 97 477 541-726-3759 Phone City of Springfield Development Services Department Public Works Department Official ReceiDt , Receipt #z 12002000000000 01312 Date: 0512312003 coM2003-00391 coM2003-00391 coM2003-00391 coM2003-00391 Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add + 7%o State Surcharge + lOYo Administrative Fee 43.00 3.00 3.22 4.60 Item Total:$s3.82 Puy-er3:_ CreditCard CORYMATTHEWS djb 000077 178006 In Person Payment Total: 53.82 $s3.82 5t23/2003 l0:05:l8AM Page I of I cReceipt.rpt ( Building/Combination Permit Status Issued 225 Fifth Street, Springfield' OR 541-726-3753 Phone 541-726-3676Fax 541-7 26-37 69 Inspection Line PERMIT NO: COM2003-00391ISSUED: 0512112003 APPLIEDz 0512112003 EXPIRES: lll2ll2003 VALUE: SITE ADDRESS: 2437 34TH ST Springfield TYPE OF WORK: Heating System ASSESSOR'S PARCEL NO.: l702l93l0lll4 TYPE OF USE: New Residential PROJECT DESCRIPTION: Install heat pump, air handler and duct work Owner: Address: MATTHEWS CORY J & SHERI A 2437 34TH ST SPRINGFIELD OR 97477 Contractor Type Mechanical Owner Contractor COMFORT FLOW MATTHEWS CORY J & SHERI A License 460 Expiration Date 06t27t2003 Phone 541-726-0r00 CONTRACTOR INFORMATION 01ts N0"t N H\S P ERI'I\\"t r0R# of Buildings: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: SETBACKS Frontyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: Range Type: Energy Path: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: oh ofLot Coverage: Lot Size: Sq Ft lst Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Impervious Surface Area: 1 ONED R-3 R\1Eu VN }TENC 180 0 {'$x;}iillrffi Sidewalk Type: Downspouts/Drains: REQUIRED PARIflNG Total: Handicapped: Compact: Itr,- Notes: Square Footage DEVELOPMENT INFORMATION Valuation Descrintion Description Type of Construction $ Per Sq Ft Page I of2 Value Date Calculated I outo D 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: COM2003-00391ISSUED: 0512112003APPLIED: 0512112003 EXPIRESz 1112112003 VALUE: Fee Description -Mechanical Issuance Fee- + l0o/o Administrative Fee + 7o/o State Surcharge Air Handling Unit Up to 10,000 Heat Pump Minimum/Adj ustment Mechanical Total Amount Paid Amount Paid Total Value of Project Date Paid st2y03 5t2u03 st2u03 5t2U03 5tzy03 512u03 Receipt Number 120020000000000t276 1200200000000001276 120020000000000r276 1200200000000001276 1200200000000001276 1200200000000001276 $10.00 $4.s0 $3.15 $8.00 $r2.00 $25.00 $62.6s 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. 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 Springlield 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 is located at the front of the property, and the approved set of plans will remain on the site at all times during {;r-ry or Signature Page? of? Date r ees raro Kequtreq lnsDecuons 225 Fifth Street Springfield, Oregon 97 477 541-726-3759 Phone City of Springfield Development Services Department Public Works Departmer^t Official Receipt Receipt #: 12002000000000 0127 6 Date: 0512112003 coM2003-00391 coM2003-00391 coM2003-00391 coM2003-00391 coM2003-00391 coM2003-00391 Air Handling Unit Up to 10,000 Heat Pump -Mechanical Issuance Fee- Minimum/Adj ustrnent Mechanical + 7%o State Surcharge + l0% Administrative Fee 8.00 12.00 r0.00 2s.00 3.15 4.50 Item Total:$62.6s Payments: Check COMFORT FLOW djb 62.6sIn Person Payment Total:$62.6s 5t21t2003 10:47:26ANI Page I of I cReceipt.rpt ,