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Home My WebLink AboutPermit Mechanical 2009-7-7 Mechanical Permit Application 12i\:~,~1",!!L,"i5fX:,',,-"'~":l'i.'fi~,';,'j'~,B\tiSli"'t'~S>0,,' c~"",'",''''''~'k""",.';~SJi'(,:1 ;iil'~~l.)gI:?AR:T:I'tIENiTr!.lJSE;QN).2~ii!!!:~1s\ ,"1:~"i~'J;t,<,",".J'.-i.,7!;.'-otlli""~"1'I'ro:<!1':_~1i$"","'l'Mlitk0ti,.!;":;~,, I Pennit n~ Uo/?'l Zo1J l' ~r 96 I Date: -7 ~7~ DC; I 225 Fifth Street. Springfield, OR 97477. PH(541)726-3753 . FAX(541)726-3689 This permit is issued under OAR 918-440-0050, Permits expire if wo'rk is not started within 180 d:iys of issuance or if work is suspended for 180 days, :' 1~"'*"'J"~:jC'AmEG0Ry,,'l'0E?:rG0NSmRD€TT0NJlYi.'~~';Wi~1 ~~,_"~_:_,__,*_~,_,-","-',~,"~.w.._~."'~~-'-,.,-~".._",,,..._.___._L~W~L~",v I ~ Residential I. D Government ,I D Commercial _ 1~~~m!S1ill~lli(ffiQ~fJ11\itlgf!Y~JiiRil~~,Q~iliIQR~~1 1 Job site address: 350 5, 1-b fit <;f _ ICi::"iI1<JNCiFIRJ) I State: (),K I ZIP: 17&)- ~~,,,:;,;;:;JJjt] (5JfJ ~~, _~~_I:~:;''''~~~II ~*~~ill!lE~9R!Iiir~QN"9.fJly![Q,~!S~y",~,~~1i~ 1 IN>)/}i.t.- IY;t., Ctf71J O/17tD11JIVCi pr"sfEJ'11 1 I 1~-lltif~if\''''~'~''''!RR0eERffi.Y$0WNER',;l'~l'i!\'X~K~~$'41 ~~':o::.~~~Jl~__",,~~_,~___...i_"'-_..:::2.m.J~......,,-,-__....\.:iiI"""b1trt...'fil..~J:i~JE;i/",?f!'"" 1 Name: eM G ;/'ft;J1f Is cJ?() I 1 Address: 'J';J'J 5[ -16 It-. 5'1, 1 I City: <;1'J'<1,iIt{lTrC~O I State: Of'( I ZIP: 97-17JJ I 1 Phone:7'4/-71? <lb 14 I Fax: I 1 E-mail: Ct-EII-~t1M[;!J&J7f;(/@A1~.t/.GtI..MJ 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 70 10. Signature: a, ,~JI!_~J~BlIil~c.m5iJI1tiLillK~1!4;'f1j5iIr'J~~~f~~1* I Business name: C ct Il- CON 71fA-q""rf>e.5 I 1 Address: I I City: I State: - I ZIP: I 1 Phone: 1 Fax: I I E-mail: I I CCB license no.: 1 1 Print name: 1 I Signature: I 440-2545-1 (Il/G8/COM) ~"'illl~'~'~~""-~EEE1~S'€RE5i!itr .;cg;."".3jJh~~~".,~___,...".._.."...,.__,.._."..","_",..,,~, i?R'1':4:~~i!i'~tef\~~/~j~~~tf),~~~;~~f>11~i5~\1 tL~~i~,lC1-!tg,!!!!~1iy:it~~~~i~-t~~Wj';ij: :81!Jl I First Appliance .. i I $79.00 !Furnace/burner including ducts and vents I Up to lOOk BTU/hr. I I lOver lOOk BTUlhr. I Heaters/stoves/vents I Unit heater I Wood/pellet/gas stove/flue I Repair/alter/add to heating apPliance/, refrigeration unit or cooling system! 11 absorption system : I Evaporated cooler II I Vent fan with one duct/appliance veri:t I Hood with exhaust and duct I! J Floor furnace including vent I Cas piping lOne to four outlets !: I I I Additional outlets (each) " Air-handling units, including ducts I Up to 10,000 CFM I I lOver 10,000 CFM I! I Compressor/absorption system/heat pump I Up to 3 hpllOOk BTU I' I I I Up to 15 hp/500k BTU I I Up to 30 hpll,OOO BTU I I I Up to 50 hp/l,750 BTU. I lOver 50 hpll,750 BTU I I I Incinerators I Domestic incinerator I $17.00 I $ $20.00 $ $17.00 $ $38.00 $ $58.00 $ $13.00 $ $9_00 $ $13_00 $ $58.00 $ $7_00 I $ $4.00 $ $11.00 I $ $20_00 $ $17.00 $29_00 $43.00 $57.00 $95.00 I $ 17 $ $ $ $ $ I Enter fee based on valuation of mec~~nical system, etc. I $ I IP~'Y'_'i""_"'KJ_, '''HIJ!l!1i"'''?,,'I'.,l,..;,,,.L'''l'll1"'jl' 'G~t, ''''j'*''T --II'" '!MISCellaneous.Jees,,,,\,,,,'~"'~',-,,,Mlltems ,"~!!~ "",.~q.~~, ' r;;~';;1\l"W);Y';'1~>\'ft"~'-!.-."'<4~';Xh'd,m~1;~'~,if~Eib'~.i(}v~ 'l'S':,'tio>" . $ea;~ ~~cost i I Reinspection il $58.00 $ -- I Specially requested inspections (per ~r.) $58.00 I $ I Regulated equipment (unclassed) II $13.00 I $ I Each additional inspection: (I) II I $58.00 $ I n~~""~A'Rp.'1fi€ANm,~i!JS--~~""""l+J!:~'1 ~~'~___" ~ ",_ " . =. "I::. ",~jtmlim1l\\_m (A) Enter subtotal of above fees (or e!1ter set _ I minimum fee of $ 79.00): . $ q(" 0 (J I (B) Investigative fee (equal to [A]) ]i $ I I (C)EnterI2%surcharge(.12x[A+B]) $ fl. '72. I I (D) Seismic fee, 1%(.01 x [A]) $ I I (E) Technology Fee (5% of[A]) I: $ 4', 'iiO I I TOTAL fees aod surcharges (A \~rough E): $tll.q,5 2.1 Enter total valuation of mechanical system and installation costs $ .2.K. II Status Issued CITY; OF SPRINGFIELD ;) " Building/C6mbination Permit II PERMIT NO: COM2009-00996 ISSUED: 07/07/2009 APPLIED: 07/07/2009 EXPIRES: 01/07/20]0 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 858 S 46TH ST ASSESSOR'S PARCEL NO.: 1802051205100 Springfield TYPE OF WORK: Mechanical Ouly TYPE OF USE: PROJECT DESCRIPTION: Air Conditioner Owner: Address: THOMPSON CARL 858 S 46TH ST SPRINGFIELD OR 97478 Phone Number: 541-746-0644 Contractor Type Mechanical Contractor CHARLES ISAAC OSGOOD License 168942 " I: '" I, , Expiration Date 03/07/20 I 0 Phone 541-988-5674 I CONTRACTOR INFORMATION' ,~UILDING INFORMATION I # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: # of Stories: Height ol'Structure Type 01' Heat: Water Type: Range Type: Energy Path: Sprinkled Building; Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft B:asement: Sq Ft Garage/Carport Sq Ft Other: OccupanfLoad: n/a I DEVELOPMENT INFORMATION , , REQUIRED PARKING Front yard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: ,T"tal: _ , Handicapped: . Compact: I PUBL~C IMPROVEMENTS' Sidewalk Type' . , t ATTENTIUN: Ure9ull'l~w reqL1lres you.o follow r'!).ownspo~fs/i>"ain~:'J Oregon U~lity Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001- Notes: 0090, You may obtain c9pies of the rules by NOT/CF.' calling the center. (N~t~:.:.he .t~!~P~~2~_ I HIS PE fumasr IUf 111~. VI vtju' '[-'''''' . - -- AUTHO RMIT SHALL EXPIRE IF T1 ""'ul,Ition Descriotion Center IS 1-800-332-2344). CO RIZED UNDER THIS PE ~Yrl," I, DescriP\r<i:1M8EoNo~~gepQ~d~nWG.i@IYNREMD'1~Mqlt' 1il~t squBa.rdeAFootage Value flY ERIOD. UIUIIJI 'p ,er or' mount Street Improvements: Storm Sewer Available: Special Instruction: Date Calculated Page 1 of2 Status Iss u ed CITV OF SPRINGFIELD ii Building/Combination Permit I, PERMIT NO: COM2009-00996 ISSUED: 0:7/0712009 APPLIED: 07/07/2009 EXPIRES: 01/07/2010 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37691nspection Line Total Value of Project Fees Paid I Fee Description + 12% State Surcharge + 5% Technology Fee 1st Appliance Heat Pump Amount Paid Date Paid Receipt Number I, $11.52 $4.80 $79.00 $17.00 717/09 717/09 717/09 7/7/09 1200900000000000782 1200900000000000782 1200900000000000782 1200900000000000782 II Ii , il I' I Total Amount Paid $112.32 I Plan Reviews I To Request an inspection call the 24 hour recording at 72673769. All inspections r~quested before 7:00 a.m. will be ma>de the same working day, inspections requested after 7:00 a.m. will:1be made the> following work day. " ; I R,e?uired I~~pection~ I II By signature, 1 state and agree, that [ have carefully examined the completed application and do h~reby certify that all information hereon is true and correct, and 1 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 Servi~es Division, Building Safety. 1 further certify that only contractors and employees who are in compliance with ORS 701.005 wili be used 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, tbat 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. II Owner or Contractors Signature Date Pa2e 2 on 225 Fifth Street Springfield, Oregon 9747'7 541-726-3759 Phone Job/Journal Number COM2009-00996 COM2009-00996 COM2009-00996 COM2009-00996 Payments: Type of Payment CreditCard cReceintl City of Spri,ngfield Official Receipt DeveIopme!lt Services Department PUlJlic Works Department 1 RECEIPT #: 1200900000000000782 , , Date: 07/Q7l2009 Description 1st Appliance Heat Pump + 5% Technology Fee + 12% .state Surcharge Paid By CARL THOMPSON Received By hjm Page 1 of 1 'Item Total: Check Number Authorization Batch Number Number How Received 602551 In Person II Payment Total: " 3:02:19PM Amount Due 79.00 17.00 4.80 11.52 $112.32 Amount Paid $112.32 $112.32 71712009