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Home My WebLink AboutPermit Mechanical 2009-6-4 Mechanical Permit Application 225 Fifth Street. Springfield, OR 97477 . 'PH(54 ] )726-3753 . FAX(54 ])726-3689 7'8'0 (;/'1/ CJ 7 This permit is issued under OAR 918-440-0050, Permits expire if work is not started within 180 days of issuance or if work is suspended for 180 days. , I I Name ~of Sonnq fuld I Address '2.\ O'-'s \ ~*' ~y I I cityS~nn~fu \0 r State:OQ. I z1P~1411 I I Phone: - 'I Fax: . c I I E-mail: I This installation is being made on property owned by me or a member of my immediate family, and is :exempt from licensing requirements under ORS 701,010. Signature: I Business name: r'Y\ eM. sheLl's IhC. I Address: Lf II 0 014 ra..{).1.f, sf I I CitySo:w.na:li.tIcf' 1 State 0l2. I ZIP 'H'f78 I Phone~9/~1tJ.l-1c-N5 I Fax51f.17'f( - ow I E-mail w..r.d<;;.e.1~f.iA.halllime..COm I I CCB license no,: ~.g7'1n . -' I Printna~ Llnd~eJ ~C4.e..th I I Si6 +('JL!:y Ba..dh I , Jc~ -1U ,\' ~~~ Q~~~J(O 440-2545-1 (11l08/COM) o I First Appliance lFurnacc/burner inc~uding ducts and vents I Up '0 lOOk BTU/hr. I I $17.00 I $ lOver lOOk BTU/hr. $20.00 $ I Heaters/stoves/vents I Unit healer $17.00 $ I Wood/pellet/gas stovc/flue $38.00 $ I Repair/aIter/add to heatingappliance/ refrigeration unit Of cooling system! ' $58.00 $ absorption system I Evaporated'cooler $13.00 $ I Vent fan with one duct/appliance vent $9.00 $ I Hood with exhaust and duct $13.00 $ J Floor furnace including vent $58.00 S I Gas piping lOne to four outlets I I $7,00 I $ I Additional outlets (each) $4.00 $ I Air-handling units, including ducts I Up to 10,000 CFM I I $11.00 I $ Over 10,000 CFM $20.00 $ I Compressor/absorption system/heat pump I Up to 3 hpllOOk BTU I $17.00 $ I Up to 15 hpl500k BTU $29.00 $ I Up to 30 hpl1 ,000 BTU $43.00 $ I Up 10 50 hp/l,750 BTU $57.00 $ lOver 50 hpl1,750 BTU $95.00 I $ I Incinerators I Domestic incinerator $20.00 I $ I Enter total valuation of mechanical, system and installation costs $ --3lI~~q I Enter fee based on valuation of mec.hanical system, ete, $ I Reinspeclion I Specially requested inspections (per hr.) I Regulated equipment (unclasscd) I Each additional inspection: (I) $58.00 $ $58.00 $ $13.00 $ $58.00 $ '(A) Enter subtotal of above fees (or enter sel minimum fee of $ 79.DO) I (B) Investigative fcc (equal '0 [A]) I (C) Enter 12% surcharge (.t2 x [A+B]) I (D) Seismic fee. 1% (.01 x [A]) I (E) Technology Fee (5% of [A]) I TOTAL fees and surcharges (A ihrough E): $ $ . Itr $Q.A~r., $ -g $ 'b.q~ $ '\1.."\'p Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2009-00783 ISSUED: 06/1912009 APPLIED: 06/04/2009 EXPIRES: 12/19/2009 VALUE: $3,639.00 , Springfield TYPE OF WORK: Heating System SITE ADDRESS: 2705 PHEASANT BLVD ASSESSOR'S PARCEL NO.: 1703220002707 TYPE OF USE: Repair Public PROJECT DESCRIPTION:' Replace ac unit Owner: CITY OF SPRINGFIELD Address: 225 FIFTH ST SPRINGFIELD OR 97477 Contractor Type Mechanical Contractor MARSHALLS INC # of Units: Primary Occnpancy Gronp: Secondary Occupancy Group: Primary Construction Type, Secondary Construction Type: # of Bedrooms: Front yard Sethack: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: Notes: Description Type of Construction ATTENTION: Oregon law requires you to .~~~I;~w ~ule~~~??te.9. by the .oregon Utility , - --.--.. . ..~...... ....,...... 1;.41.0 ""ClIUllIl In rlflC oCr) ....n.-t ^"..." .1____ ........_ I GONTRACTORJNFORM~:rION'1952-001- , ,u. rules by calling the center. (Not,,:. the teleph@". . number for the Oregon ~!~!\.n.~l)tifica~&~lrahon Date Center is 1-800.3ZJi2-'iQJ44 \ 12/2312009 BUILDING INFORMA nON I Phone 541-747-7445 # of Stories: Lot Size: Height of Structure Sq Ft 1st Floor: Type of Heat: Sq Ft 2nd Floor:' Water Type: Sq Ft ~asement: NOTlC~ange Type: Sq Ft Garage/Carport !:Energy Path: Sq Ft Other: THIS PElSp'liffiIflHI~l!.i@,1!fg:RE IF TH~~JORK Occnpant Load: AIITunn'-..,..,...I':....-r; _. - -'.._-~ H"'j'!\ ,,,,. --"....,.. I'> NUl CnDEJYiFlI!.0P,M-E~TdNRORMATlON.11 ANY 180 DAY PERIOD. ' --,,- Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: REQUIRED PARKING , Total: , Handicapped: Compact: I PUBLIC IMPROVEMENTS I Sidewalk Type: Downspouts/Drains: I Valuation Descriotion I $ Per Sq Ft or multiplier Square Footage or Bid Amount Valnc Date Calculated Paec I 01'2 Status Issued CITY OF SPRINGFIELD Building/C~mbination Permit PERMIT NO: COM2009-00783 ISSUED: 06/19/2009 APPLIED: 06/04/2009 EXPIRES: 12/19/2009 VALUE: $.:3,639.00 225 Fifth Street, Springfield,:,OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769Inspection Line Bid Amount Use Bid,Amonnt $1.00 3,639.00 , $3,639.00 , 06/04/2009 Total Value of Project $3,639.00 Fees p~idl Fee Description + 12% State Surcharge + 5% Technology Fee Mechanical-Value Minimum/Adjustment Mechanical Amount Paid Date Paid $9.48 $3.95 $77.50 $1.50 6/19/09 6119/09 6/19/09 6/1 9/09 Receipt Number 120~900000000000713 1200900000000000713 1200900000000000713 120Q900000000000713 Total Amount Paid $92.43 SUB Review '11 I' 06/04/2009 I Plan Reviews I 06/0512009 APP DH See attached documents for sub approval. 'I To Request an inspection call the 24 hour recording at 726-3769. All inspections requested before 7:00 a.m. will be made the sa,me working day, inspections requested after 7:00 a.m. will:;be made the following work day. .1 R~f!uirerl Tnmeetions I Rough Mechanical: ~rior to Cover " Final Mechanical: When all mechanical work is complete. II By signature, 1 state and agree, that I have carefnlly examined the completed application and do hereby certify that all information hereon is true a!,d correct, and I further certify that any and all work performed shaJi. 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 willibe made of any structure withont permission of the Community Servi~es Division, Building Safety. 1 further certify that only co~tractors and employees who are in compliance with ORS 701.005 will be used ou this project. I further agree to ensure that all required inspections are requested at the proper time, that each a~dress 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. I' ~ 'i /0 r /'/?/..?~ '~-P---' t/ ' Owner or Contractors Signature I ~ -/9-D?" Date Page 2 01'2 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone City of Spri~gfield Official Receipt Development Services Department PuJ:)!ic Works Department 11 Job/Journal Number COM2009-00783 COM2009-00783 COM2009-00783 COM2009-00783 Payments: Type of Payment Check Cash Job/Journal Number COM2009-00783 COM2009-00783 COM2009-00783 COM2009-00783 Payments: Type of Payment Check Cash cRcceintl RECEIPT #: 1200900000000000713 Date: 06/1'9/2009 Descriptio,!) Mechanical-Value Minimum/Adjustment Mechanical + 5% Technology Fee + 12% State Surcharge Paid By MARSHALL'S , Item' Total: Check Number Authorization Received By Batch Number Number How Received CJC 20709 In Person " In Person Paymert Total: Description Mechanical-Value MinimuinJAdjustment Mechanical + 5% T~chnology Fee + 12% State Surcharge Paid By MARSHALE'S Item Total: Check Number Authorization Received By Batch Number Number How Received CJC 20709 In Person In p:erson Payme,nt Total: "I , '. II Page I of I II :32:30AM Amount Due 77.50 1.50 3.95 9,48 $92.43 , Amount Paid $90.68 $1.75 $92.43 Amount Due 77.50 1.50 3,95 9,48 $92.43- Amount Paid $90,68 $175 $92.43 6/19/2009