The URL can be used to link to this page

Home My WebLink AboutPermit Mechanical 2009-5-12 ~. Mechanical Permit Application 1;:;!j:'DEPARfMENT:usE'oNi:y,r~\t:1 1:~;:'::.z);;I~ &'S'7,.liJ, I Date: S -/2 - 09 I This pennit is issued under OAR 9111-440-0050. Pennits expire jfwork is not started within 180' days of issuance or If work is suspended for 180 days. 1~.:tIL.;\cM"EGQRXi.QI'IcdNS:rRU(;:T1bNrg€il~.IJ!I~ I E'Residential I 0 Government I 0 Commercial l@r.l'JQEll$IJ't:,~iNr-;(jRrM.1J(jN~~NQWi!bGA'IldNII'.r~1 I lob sile address: ,/17 S 5',:5 q K ':;f, I City: Sf' r .' ..Sf::..... lei I State: 0 t< I ZIP: 97 'flf? I Subdivision: . 1 Lot no.: 1.11:IIMtl:WI.11.p_e$~~'~t(QN:~'qFJA~QB~Yi~~fkl~%1.~al I,vr.f:a.II,,-;',.," '2./ c. 1',,//... t ;IVS~ i-- ; /II lei..; r{ I'v~ ". .-e~. '.rf: I(~ )11 u.so ltJ' If{ l:. cO 225-Fifth Street. Springfield, OR 97471. PH(541)726--3753 . FAX(541)726.3689 I Name: ~ I Address: J 175 S, '3 "j/-J.. S'j, I City: " SiPr.'"" /.-1<-( I State: 012.- Phone: I Fax: E-mail: This installation is being made on property owned ~y me ora, member of my immediate family;and is exempt froin licensing , requirements under ORS 701.010: , , Signature: I 1."fd~'A'f'4G.bN"M<:::r:Q~IN,S'I~iJ.I!A1JQNf_j\'I_.1 'Business name: fJ....- f:...cf Parl-''''''A (' ('/.;.,.,' I Address: '7f'r CAcr-/I,'r-p C,'I/J;. I ICity:E't:,c;-p .~Q - I State: Ot2 I ZIP: '1)'1tJ:Z .1 I Phone: W'--34f>' &?.,,, I Fax: -'it/S'"'-f?05-.b I I E-mail: t!U<;c(2iv.RS'UI4!..-f'r'~ -Qlfc:,)"". (CJI/(I I CCB license no,: - //9!)" 9 .s-' I I Print name: A~' 1 J( '-' /'/",' ~'" n. I I Signature: ' (7 A. Y:;,.LL?U~ I , ./ I ZIP: 974'711 440-2545-) (l1/08/COM) 1 First Aooliance IF'urnace/burner including ducts and vents I Up to lOOk BTU/hr, I I I Over lOOk BTU/hr, I Heaterslstoveslvents I Unit heater Wood/pellet/gas slove/flue I Repair/alter/add to heating appliance! refrigeration unit or cooling systeinl absorption system I Evaporated cooler I Vent fan with one duct/appliance vent I Hood with exhaust and duct I Floor furnace including vent I Gas piping I One 10 four outlets I I I Additional outlets (each) I Air-handlin2 units, including ducts I Up 10 1O,000CFM I $11,00 I' $ lOver 10,000 CFM I $20,00 I $ I Compressor/absorotion svsternlbeat Dump 1 Up 10 3 hpllook BTU 1 I $17,00 I' $ I Up to IS hpl500k BTU I $29,00 I $ I Up to 30 hpll,Ooo BTU $43,00 $ I Up to SO hpll,7S0 BTU $51,00 $ lOver 50 hpll,750 BTU $95,00, $ I Incinerators I Domestic incinerdtor I I I I I $17,00 I $ I $38,00 I $~g.1 I I I I I $11,00 I $ $20.00 I $ $58.00 $ $13.00 $ $9,00 $ $13.00 $ $58,00 $ $1,00 I $ $4,00 ' $ $20,00 I $ I Enter total valuation of mechanical system and installation costs S"",""- . I Enter fee based on valuation of mechanical system, etc, I $ I I~Mis~+elirri~W:it'i:1i"""'''''lJ~;S;;;ll1.IrIi''';jI'lieW~Ostl~ .1'01811'1 ' %",>",q"~"\""._"".2,_~,;,,,L!!~gHJ~{@~i14t',l~~~&:4~'ea~f,i~1 **,~ooStW;~ I Reinspection \.. -, $58.00- $ Specially requested i~spectinns (per hr,) $58,00 $ I Regulated equipment (unclassed) $13,00 $ Each addilionalin'peclino: (l) $58,00 $ I 'Il~APP.mCANtl('fsE~.i!l1!!iIT~ (A) Enter subtotal of above' fees (or eoter sel nq cV minimum fee of $!!"Q!!)' $' L ' I(B) Investigative fee (equal to [A]) $ I I (C) Enter 12% surcharge (,12 x [A+B]) $ C-f, .~ I (D) Seismic fee, 1%(01 x [A]) I $ '1 I (E) Technology Fee (5%0f[A)) I $ ~~,J-{'f> I TOTAL fee, and ,urcharges (A through E): $ Y'd [, 9'.3 CITY OF SPRINGFIELD Building/Combination Permit Status Issued PERMIT NO: COM2009-00659 ISSUED: 05/12/2009 APPLIED: 05/12/2009 EXPIRES: 11112/2009 VALUE: 225 Fifth Street, Springlield, OR 541-726-3753 Phone 54 J -726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 1173 S 39TH ST ASSESSOR'S PARCEL NO,: 1802064108300 Springlield TYPE OF WORK: Wood Stove TYPE OF USE: New Residential PROJECT DESCRIPTION: Wood pellet stove insert Owner: KINDT WILLIAM R & LINDA L Address: 88928 BRIDGE ST SPRINGFIELD OR 97478 'CONTRACTOR INFORMATION' Contractor Type Mechanical Contractor JULIE AMENT & PAUL KUHLMANN License 119295 Expiration Date 12/16/2010 Phone 541-345-8056 BUILDING INFORMATION' # of Units: Primary Occnpancy Group: Secondary Occupancy Gronp: Primary Construction Type Secondary Construction Type: # of Bedrooms: # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Bnilding: Lot Size: Sq Ft I st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: n/a I DEVELOPMENT INFORMATION I REQUIRED PARKING Front yard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: Total: Handicapped: Compact: ___..:,.,.,,., ,,^" t,... S I r,,,....._. treet mproyements-:. - . 'V&.;,. S S TL~I" 'I "iii' tonn ewer'~Val a, ,~,:!IT SHA ' Speciallnsttu'CtioJj,:WEO UNoiL EXPIRE IF THE WORK r:OMMENCED OR IS R THIS PERMIT IS NOT Notes: . ,NY 180 DAY PERIO~BANOONEO FOR ,.. '....\Il\VIII.. "-"''-''tj'"'" ''-'0. . -~,- . I PUBLIC IMPROVEM~i:'I,T'~,'I'ules adopted by the Oregon Utility Notification Q~~tAr Jhose rules al e set forth S.oewalk Type: OAR 952 001 in OAR 952-001-0Ul U lI.10ugh -- 0090, You nD.~wrispoutslDriiinst the rules by calling the center. (Note: the telephone number for the Oregon Utility Notification Center is 1-800-332-2344), I Valuation, Descrintion I Description Type of Construction $ Per Sq Ft or multiplier Sqnare Footage' or Bid Amount Valne Date Calculated Paee I 01'2 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Fee De.scription + 12% State Surcharge + 5% Technology Fee 1 st Appliance Total Amount Paid Amount Paid $9.48 $3,95 $79,00 $92.43 Total Value of Project Fees Paid' I Plan Reviews I Date Paid 5/12/09 5/12/09 5/12/09 CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2009-00659 ISSUED; 05/1212009 APPLIED: 05/1212009 EXPIRES: 11/1212009 VALUE: Receipt Numher 2200900000000000518 2200900000000000518 2200900000000000518 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, Pellet Insert: After installation I Reouirerl I nsoections I rrll I I I 1~ r I I I II By signatnre, I state and agree, that 1 have carefnlly 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 wurk 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 pl'oper 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. (j~ A- ~ Owntr or Contractors Signature Paee 2 of 2 (:;;-/2- Of Date 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2009-00659 COM2009-00659 COM2009-00659 Payments: Type of Payment CreditCard cReceintl RECEIPT #: Description I sl Appliance - + 5% Technology Fee + 12% State Surcharge Paid By JULIE AMENT City of Springfield Official Receipt Development Services Department Public Works Department 2200900000000000518 Date: 05/12/2009 Item Total: Check Number Authorization Received By Batch Number Number' How Received nJm 03030c In Person Payment Total: Page I of I 1: II :25PM Amount Due 79,00 3,95 9.48 $92.43 Amount Paid $92.43 $92.43 51! 2/2009