HomeMy WebLinkAboutPermit Mechanical 2009-9-11
ElI/Er6/2ElEl9 11:11'1 ,7263676
CITY OF SPRINGFIELD
PAGE Ell
CITY OF sPRr:\GdEr.n. OREG,o:\'
I '_
22S Fifth _. J,,', .L~ OR 97471. PK(541)721S-3753 . FA.lC(541)726-3689
H;;;DE~~(t~~~}?:;?,"
(J..~~~ I Permit n," (\q -I ~4?>
a:.. [Date: C\l ntoq
Mechanical Permit Application
This permit is Issued:,uader OA1l9I~SO. Pennib es.pire if worle is not started withia 180 day! of i5sllaoce or if work is
su.,,,,,oded for 180 days.
NOTICE:
THIS PERMIT SHALL EXPIRE IF THE WORK
AUTHORIZED UNDER THIS PERMIT IS NOT
"
COMMENCED OR IS ABANDONED FOR
ANY 180 DAY PE~IOD. ,~ ,~\J:.
, ~r\<O~ &- 6.:~~
~!'vl\) ,~ "
" " \~ ' ' ~~.
140-2545.1 (11108lCOM) ,
~~~&lf?;~w.:0i':.'.':;;;{">.;;'ffi"i\'f2';3'i~,ScHEnOLE.~~(.~~e..Jii;{il ~" i
~~' ';~=:':_.l";;i~~r.ti~~.
I Cjty:s,Qrl~\.'.'ejj..l I Slate: IJP _ I ZIP: q 7C/n I Up to lOOk BTU~ I I $17.00 I $ ,I
I . . . <.J' '1 lOver lOOk BTUlhr. no.OO $ I
~~~~~=:;'~-:I'~"'~~ .1:'1' =::11;~1
~f1.~:~~~~~~~R;1$~t)vm.E8:~~~j\;,~:t~:tJ;~[:~;~{:;:;)t;'.::;:.:'; ::~":no=or CQOhng systcm/" $58.00 '. S .
Name:r7 {VI iJl.Q ..co. r e...cU ).p "1:::,. I I,EV8pOrull:d cooler' 'I I $13.00 I $ I
I Address:C}t.J, 7<, ,~+:- J' I Vent ran with one ductI_lian.e vent I I 59.00 I s I
I . 'l'! l'] 'I -f}' I q I Hood with exhaust ."d duct I I $13.00 I $ I
CIty: -:;.or. N4.....,;1"/ (1:- ' State: () r. _ ZIP: [ltl77 I I f100rfumllCeihCludillg venl I I $58.00 I s I
Phrmc:SzJI- 7ili;,~ 7(YI.3 I Fax: - - I Gas piping J
E-mail: I One tofoUT outlet> I I $7.00 I $ I
This inotallatio,,' is bClng made on ...-r-') oWPed by me or a I Additional outlets (eocb) U.OO $ I
member of my immciliatc family, and IS exempt frOm licensing I Air-bandling IIOils. induding ducts
requirements IDlder ORS 701.010. I Up to 10,000 CFM I I $11.00 I $
Signature: " lOver 10,000 CFM S20.0G I $
"~~~~;~~~~~~~~'~:;:"":"::('111 ~:~r:::~:r~~:~~T~Si,'!~~~#~~!,~:
17' L t It I VI) to lS trpI.500t\'I~f;'H"",...~;......... ,...""~~.. Th:'d.~ r~~rb ~ot f"rtl
Address: lJiW /" ' I Up to 30 hp(1.D<\9,~Q~?-nrl1-0D1'O thrbu~p ~2-001
City: ~~i I State:o{L I ZlP:q 7CfOd I I Up 10 SO hp/1.700JlW You may obt~in ccjpiESSllDG' 9 $ules b"
'Phone:s-z/f1'i~/-&,'~ I Fu:~Y(l:!l~/-~ I Over SO hpll,7S0 Jmltlng the centerl lNqte: j!i6!dOl 91Snone 1
I I...'neraton numoer TOr tne ur~' fUll ULIIIlY l"IIUllIJl..ii;t.LlUIl
E.-mail:.. J\.. ~ _ ~
I CCBlicenscno.: t'lM I Oomcstiein_:.._.,~. \;enter,IS lj8uUf"~f'$
'Printname: JI~ II.,\ ~^<<-ffa. :;'~:t~~~'*i:i;~~~~~C~~:i';(~}~T>,~~'t;ifi';;'~Jii;'li,
I Signature:c:i< j1A.-A~ and ins1allationeosts 5_
tEnter fee bQed on valuation ofmech."ical~. eto. I s
;,Mt$cell;;iiC!Ci~ii'''':~?t?; >;;;:;"'~~'~]}:'~1.i!1OU1;{:l'
'~ein;';;~~~"'<'-"""""'" '''1'''' '~: {i'i-""'i
I Speciolly requested inspections (perM.) I SS8.00 $ I
I Regulated equipment (lHlClossed) , I $13,00 $ I
I Each additiona' inspection: (I) , i' I 558.001 $
r~g~~~i7;1
I (C) Enter l2%surehatge(12 x 1MB]) $ " 'f, <C- ~;'. i -\.~
I (D)Scismicfee.l%(,OI ~[AJ) S-e- I
I (E) TeehnolosrFcc (5% of [A)) " $~::'--, ,-:. ~ 3. q5'
, I TOTAL fees ond nrcborp;. (A through E): I $,1'~;q,"i[:d
."i'... ''';~
~.q5
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Status
Issued
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2009-01343
ISSUED: 09/11/2009
APPLIED: 09/11/2009
EXPIRES: 03/11I2010
VALUE:
225 Fiftb Street, Springfield, OR
54I-726~3753 Phone 'I
541-726-3676 Fax "
541-726-3769 Inspect\on Line
SITE ADDRESS: :'947 B ST
ASSESSOR'S PARCEL NO.: 1703354200100
Springtield TVPE OF WORK: Wood Stove
TVPE OF USE: New
PROJECT DESCRIPTION: Installing freestanding woodstove in residence
Residential
Owner: HARGREAVES TIMOTHY
Address: 947 B sr'
SPRINGfIELD OR 97477
Phone Number: 541-746-7043
I CON~RACTOR INFORMATION I
Contractor Type
Mecbanical
Contractor License
EMERALD SWIMMING POOLS OF ORE IN 11294
BUlLDl,NG INFORMA nON I
Expiration Date
10/22/2009
Phone
541-688-1090
# 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 2."d Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
n/a
I DEVELOPMENT INFORMA nON I
, REQUIRED PARKING
Frontyard Setback: Overlay Dist: Total:
Side 1 Setb'\~JTlCE' , . # Street Trees Rqd: ATTENTION: OregoJ;lr~if~8B~,i~ you to
Side 2 Setback:~' Paved Drive Rqd: follow rules adoptea(';J'}'1!\~Ceregon Utility
Rearyard sJtH~'cJf:'ER.MIT SHALL EXPIRE IF THE %'GIFll1Ot Coverage: Notification Center. Those rules are set forth
Solar Setba~RH~?:~\~~~ ~~D:~\~~~:~;5:~~I~~Sf, NOT . ~v~~R 1~5}:,~~: .~~,~~, :~~f'~~~ ~~,~v~~~~~O~;
ANY 180 'DAY PERIOD. . I PUBLIC IMPROVEMENTS I calling the center. (Note: the telephone
Street Improvements: nUlSia~wlllk Ty.,Qregon Utility Notification
Centef IS 1-800-332.2344).
Storm Sewer Available: DownspoutsiDrains:
Special Instruction:
Notes:
I V al~ation Description I
Description
Type of Construction
S Per Sq' Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Paee 1 of 2
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspecti'!,n Line
Fee Description
+ 12% State Surcbarge
+ 5% Technology Fee
1st Appliance
Total Amount Paid
Amount Paid
$9.48
$3.95
$79,00
$92.43
Total Value of Project
F~e~ Paid I
I Plan Reviews I
Date Paid
9111109
9111 109
9111 109
CITY OF SPRINGFIELD
Building/Combination Permit'
PERMIT NO: COM2009-01343
ISSUED: 09/11/2009
APPLIED: 09/11/2009
EXPIRES: 03/11/2010
VALUE:
Receipt Number
2200900000000001033
2200900000000001033
2200900000000001033
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.
,
Wood Stove: After Installation.
I Reollired I nsnections I
By signature, I state a~d agree, that I have carefully examined the completed application and do hereby certify tbat all
information hereon is trne and correct, and 1 fnrther certify that any and all work performed shall be done in accordance with
the Ordinances of the 'City of Springfield aud the Laws of the State of Oregon pertaining to the work described herein, and
that NO OCCUPANC:Y will be made of any structure without permission or the Community Services Division, Building Safety.
1 further certify that ';'nly 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 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 construc~ion.
Owner or Contractors Signature
Paee 2 of2
Date
225 Fifth Street
Springfield, Oregon ~7477
541-726-3759 Phone"
!i
Job/Journal Number
COM2009-0 1343
COM2009-0 1343
COM2009-0 1343
Payments:
Type of Payment
Check
cReceintl
I, RECEIPT #:
De'scription
1 st Appliance
'" 5% Technology Fee
,-t; 12% State Surcharge
Paid By
EMEIl.ALD SWIMMING
POOUS
City of Springfield Official Receipt
Development Services Department
Public Works Department
2200900000000001033
Date: 09/11/2009
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
KR
By Mail
74135
Payment Total:
Page 1 of 1
9:21:40AM
Amount Due
79.00
3.95
9.48
$92.43
Amount Paid
$92.43
$92.43
9/11/2009
09/11/09 FR1 09:37 FAX 5417263689
CITY OF SPRINGFIELD
IgJ 001
*********************
*.* TX REPORT *..
****************~****
TRANSMISSION OK
TX/RX NO
CONNECTION TEL
CONNECTION ID
ST, TIME
lISAGE T
PGS, SENT
RES liLT
1534
94310203
09/11 09:35
01'46
4
OK
CITY O~ SPRINGFIELD
Building/Com~ination Permit
.
Stat~s Issued
i
225 Ififth Street, Spri~gfield, OR
541-726-3753 Phone
541-126-3676 Fax
541-126-3769 Inspection Line,
'. Jl
PERMIT NO: COM::009-01343
ISSUED: 09/111 W09
APPLIED; 09/11/ tO09
EXPIRES: 03/11/ WIO
VALUE: '.
,
SITE ADDRESS: !i 947 B ST Springfield TYPE OF WORK: Wood Stn 'e
ASSESSOR'S PARCEL NO.: 1703354200100
: TYPE OF USE: New
PRO~ECT DESauPTION: InstalJing freestanding wiondstnve in residence
i
i
Residential
ownbr: ,
I
Addie..,
I
I
I
I
i
Conin-actor Type
Mec~anical
HARGREA YES TIMOTJ'lY
941 B ST.
SPRINGFIELD OR 97417
Phone Numb ~r: 541-746-1043'
I CONTRACTOR ~FORMATlON }
Contractor License
EMERALD SWflV1MINC POOLS OF ORE IN '11294
BUILDING INFORMA,~lON .
Expiration D de
10/22/2009
Phone
541-688-1090
i
# ofUllits:
Prinlary Occupancy. Group:
Secolldary Occupancy Group:
prinJary Construction Type
I '
Sccondary Construction Type:
# of ~edrooms:
# of Stories:
flelgh! ofStrueturc
Type nf Heat:
Water Type:
Range Type:
Energy Path:
Sprinkled Building: n/a
Lot Size:
Sq Ft 1st Flo Jr:
Sq Ft 2nd fl.IOI':
Sq Ft Basem ont:
Sq Ft Garug, 'Carport
Sq Ft Otbcr:
Occupant L( ad:
!
i
I
I
Fron~ard Setback: Ovcrlay Dist:
S~de ~ Setb~~T:CE: # Street Trees Rqd:
SIde F Setba~' _'.. Pavcd Drive Rqd:
Rea~ard Seffll~it~M'T SHALL EXPIRE IF THE WRt Coverage:
,Sola~ Setba~~~~!;I,~.E. t;:~D,~R.~~I.~!E~!I~~~S_ NOT
I DEVELOPMENT INFORMATION I
RE( UIRED PARKING
Tot~:
ATTENTION: O!'ego~lllVIrB~I!~~~ you to
follow lI.'les ado:JtecfiJf P.'!N:lregon UTility
Ncl;jication Center. Thas( rules are set forth
in OAR 952-001-001 0 thro Jgh OAR 952-001-
" '