HomeMy WebLinkAboutPermit Mechanical 2009-4-7
Thl. perlldt i. ;.."ed "nder OAR ,918-440-0050. Permits expire, if work i. nnt .tarted within 180 day. of issulUlce Or if work i.
.u.pended for 180 d.y..
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l.Job.itcaddress: 5134 l'l!'I\~("i::1 t.l"'l"''J _
I City; ~~+'Ir1 IStatc: OR fZIP: Q"1.l.\iB'
I Subdivision: I Lot no.:
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Name: r.::: ""PC'< ~f"/"rrlf),\
I Addrcss: '5134- m\~F'rAl (1')<,\,\ j
I City: ':'\p~\n I State: OR I zrr:Ql411<' I
I Phone: - - I F~: .
E-mail: " !
Tbis installation i. being made on property owned by me or .
member of :my immediate famjly, and is ex.empt fTom licensing
requirements under ORS 701.010.
Signature:
'\"l"'I'" I'll" ""....__.."",.1............"'..........'1111":1,','","",'""",.",,, 'II'
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Bu.sinessname: Q('r(\+Iv-t F\N,,"\
I Address: 1'15\ ten S-I'. J
I City: SO-\C'\ rI I State: OK I ZIP: Qill'111
'Phone: '- - 1dlp.Qltri I Fax: -14'l-'1al'+j
I E-mail: J
I c~lJJ1~,\;;';-1
I PrinTI;j,~eP W I I. to IF iiiE ','VORl( I
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Sign,a\'31 . FOR
A~80
04/06/2009 15:21
7477274
'i
Mechanical Permit Application
. - .
err.y OF SmUNGFIELD, OREGON
225 ptnh Street. Springfield, OR 97477 . PH(541)726-3753 , FAX(S41)126..3689
CaLLlcl ~Ol.L. P- \~ e.' C-ho.r~ e..
Qfecld: furci? t \ I Q. ~
440,2S<5.J (lIlOBlCOM)
COMFORT FLOW HEATING
PAGE 01/01
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Permitno,J'q - Ul Q I
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First Atmliance
Wbr.nac:e!burnil!f Inc!udin~ dutbl ~nd vOnts
I Up to 1 Oak BTU/hr. I
I Over lOOk BrUthr. I
I J.1catershctoves/vents
I Unit heater
j Wood/pellet/gas stovelfltle
I Repnir/altcr/add to heating applinnc-c:/
refrigeration unit or c('Ioling system!
absorpti('ln system .
I Evaporated cool.r I
I Vont fan with one ductlElpplian~e vent 1
I Hood ",ith o<hausr and duct I
LFloor~tJ'lac:ejncluding'Vcnt I.
I 1;.. pIping
I One to fouroutle,. $7.001 $
I,
I Additional outl." (eoell) I $4,00 I $ 1
I Air-hAndling units, inc1udin~ ducts -~
I Up to 10,000 CFM I $11.00 I $ j
lOver 10,000 CFM I I $20.00 $ J "
, Comnrossor/absorntion sv.teDl/h""i "limo 1 '
I Up to 3 hp/lOOkBTU I' $17.00 I $
I Up to I S IIp/SOOk .8TU $29.00 I $ I
I Up '0 30 hpi! ,000 BTU I $43.00 I $ I
I Up .150 hp/l, 7S0 BTU I $57.00 I $ J
I OVcrSo hpll,7;0 BTU $95.00 $ I
r Incinerators J
j Domestic incinerntcr I I $20.00 I $ j I.
1,.i!C&'~ftfli:!lilR \ .%'i\\:~11'1~'!\~~~~lw:li,!mlf'I"111:'III1lli.\'\\\.'\:lb~1:jt~~\'I'~:~j.~iii~~:r.;~\',i. )'I[\-:~:~~~:'B!,~;{j..\~,<',ilii,~
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I Enter ,oral v.~fII1['~~.eI'lJ~nlaw reqUlfes you 0
and inst.lI.ti9~!'iQS"','~"-=--"rl""tArl h)1 thA Oreaon Utility
I Enter f.. b~jI1\-\!IlH)'l\iffiFr1Jl.ph"!'!~!'i~'ll9l1J$tare ~e$forth I
!il\lilll'!liiiJii " , , " . ~j;\I~\i:61!1i'iilll\!W '.' -', ni1~*'
\I'~~~:;,:~~ ., ' ~'. "OU";1~70~~~i~t;" "'~'t'l~g'tjpl
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1 Speeially ...qu'e'l1yc\'IMJ~b\lq~~~~~~J ~ 'ili,,~~MAf
I R.gu'.""'.qI,\jlM~';;t(~~r~~I;;=S(k.~_~i!<f,P.1 $ I
11!..h nddition.1 in'pee~on: (I) . 1- I $58.00 I $
~1lI\\M\\II1IJ~I;!~I~r"lilr. ~\W[~lI\\1lD\.:
(A) Enter subtoml ofsbove fcclS (or entQr Sef ;j q 00
I minimllm fee of S 79.0Gl' . $ . I _
I (9) InvcRtigativcfe. ("'lUR' to [A]) $ I
I (C) Enter 12% ,uroll.rge (, 12. [A+B]) $ I
(D) Seismic fec, 1% (,01 . [A]) $ I
I (E) Teehnology Fe. (5% of[All $ I
I TOTAL fees and sureborge. (A thro'tgh E): I $ J
~ 'I a.. 'b:l.
$17.00 I $
.~20.00 I $
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j
J.
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517.00 ,
$38.00
$58.00 I $
$13.00 $
..$9.00 $
$13.00 $
$'.,00 I $
$1'l
$
Status' Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-37691nspection Line
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2009-00461
ISSUED: 04/07/2009
APPLIED: 04/06/2009
EXPIRES: 10/07/2009
VALUE:
SITE ADDRESS: 5734 MINERAL WAY
ASSESSOR'S PARCEL NO.: 1802033209900
Springfield TYPE OF WORK: Heating System
TYPE OF USE: New
Residential
PROJECT DESCRIPTION: Replace Heat Pump
O'wner:
Address:
GREEN BRENDA S
5734 MINERAL WAY
SPRINGFIELD OR 97478
I CONTRACTOR INFORMATIO~ ,
Contractor Type
Mechanical
Contractor
COMFORT FLOW HEATING CO.
License
460
Expiration Date
06/27/2009
Phone
541-726-0100
BUILDING INFORMATION. I
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
# of Stories:
Height of Structure
Type of Heat:
Water Type:
Range Type:
Energy Path:
Sprinkled Building:
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
n/a
I DEVELOPMENT INFORMA TlON I
REQUIRED PARKING
Frontyard Setback: Overlay Dist: Total:
Side I Setback: # Street Trees Rqd: Handicapped:
Side 2 setbUfli..:TIf'E' Paved Drive Rqd: ATTENTION: Oregon' la*P~r&s you to
Rearyard smiktl& . % of Lot Coverage: follow rules adopted by the Oregon Utility
Solar SetbacMlS PERMIT SHALL EXPIRE IF THE WORK Notification Center. Those rules are set forth
~~~; E-~~EE~ ~~:;T{A~~~ciJJ,1kk';i~PROVEMENT~I;"~ou~;;;~; -~bt~in';~';Pi~~ ;!t'~~:r:u~e~:~y
Street ImpA.'llMn1l\lf);{lAY PERIOD. callin[Std>ew.nRtjlyPJ~ote:the telephone
number for the Oregon Utility NotificatIon
Storm Sewer Available: QJmnWQgt$te~~2-2344).
Special Instruction:
Notes:
I Valuation DescriDtion I
Description
Type of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Paee 1 of2
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Total Value of Project
Fee.s paidJ
Fee Description
+ 12% State Surcharge
+ 5% Technology Fee
1st Appliance
Heat Pump
Amount Paid
Date Paid
$11.52
$4.80
$79.00
$17.00
4/7/09
417109
417109
417109
Total Amount Paid
$112.32
I Plan Reviews I
. CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2009-00461
ISSUED: 04/07/2009
APPLIED: 04/06/2009
EXPIRES: 10/07/2009
VALUE:
Receipt Number
1200900000000000239
1200900000000000239
1200900000000000239
1200900000000000239
To Request an inspection call the 24 hour recording at 726-3769. All inspections 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 Rem/ired T nsoections I
Rough Mechanical: Prior to Cover
Final Mechanical: When all mechanical work,is complete.
By signature, I state and agree, that I have carefnlly examined the completed application and do hereby certify,that all
informalion 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 slructure 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 trsed on this project.
[ 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.
t __r
DID. ~.~)l ___ ~
Owner or Contractors Signature VI) 0, 0 '0 Q,
c.ovn~ ftoc....:J
r<-~ .
Page 2 of2
Date
225.Fifth Street
Springfield, Oregon 97477
541,726-3759 Phone
Job/Journal Number
COM2009-0046\
COM2009-0046I
COM2009-0046I
COM2009-0046 ]
Payments:
Type of Payment
CreditCard
cReceiotl
RECEIPT #:
Description
I st Appliance
Heat Pump
+ 5% Technology Fee
+ 12% State Surcharge
Paid By
COMFORT FLOW
City of Springfield Official Receipt
Development Services Department
Public Works Department
1200900000000000239
Date: 04/07/2009
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
KR
001780 Fax
Payment Total:
Page I of I
8:32:17AM
Amount Due:
7900,
17,00'
4,80
11.52
$112.32
Amount Paid I
$112.32.
$112.32,
4/7/2009