HomeMy WebLinkAboutPermit Mechanical 2009-10-2
This permit is issued under OAR 918-440-0050, Permits expire if wurk is nut started within 180 days uf issuance ur if wurk is
suspended fur ]80 days.
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~esidential I 0 Government I 0 Commercial I
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I Job site address: '1:d-.4 ~ O(t-1v I
I City:<S'raJ v\r1fJi<>1 P I St".tefi)fl I ZIPQ7't')>../ I
I Reference: \ it\ 0'0 f2.\.o\'2. ITaxlot.O\O\O 1
I. . "'!"DESCRIFf,'f~()N::()~WQRi(:":.''''':';',:'~'' ""I
I I tfJsitl- It Oc> ) 1_"-1 I ^JsPl'lf I
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I Name: A-i/VlY \')OAhAR/v
I Address: 2-2LI Y - AI 0; Irv
I City: S. Oii., 'vIr; r:..1 ("JIll IState,((rtl/.... I ZIP{:{)'r.f>)
I Phone Q5:Z: GJI<< I Fax -
I E-mail:
This installation is being made on property uwned by me or a
member of my immediate family, and is exempt ITom licensing
requirements under ORS 701.0]0,
Mechanical Permit Application
225 Fifth Street. Springfield. OR-97477 . PH(541)726.3753 . FAX(54 1)726.3689
Signature:
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I Business name: ~,Q() &. ~P1iY( WI e't1Jt
I Address C; ~~,AI) ~-I Vi - _
I City c;.?~1 1-1(.1]:1((\ u I State:tf)/l I ZIPq'rLf70
I Phone: 7b/- 1,-- (,,2 cJ I Fax:
I E-mail:
I CCB license no,: ,?J, 74 ~
I Print name: (-;. A euJ () ~ CltrHV
I f1Al'lU II~:. .:. WOR~
Signature: XI.c4JIV)Jf.RMV~.~JIJd~XPI_R~~~~~!It'!. W"
. AUTt'IORIZED uHill'f(1 Mlv rell"''' .-:."
COMMENCED OR IS ABANDONED FOR
,~y PERIOD
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440.2545.) (11/08/COM)
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I Permit no. C,Cj - t Lit 0 q
I Date: I () I :;y I oq
, ""!';\'''FEESCHEDULE';'" '''''I
li1R~~ i'~"E?~tiait~-i$r[~4~~~~;':';l.Wi1~~~~~} 'QtY':ljr;f.~~~~~t'II)~' ~.,~)I~~!a~"1
g"~-", .._......."~>,=~,.1,.,,""':];t~14r'o:'~1~'I)~.,S~,-r::.*,"it~ .... ~ ,.,~ ~~ea.~~-=<t ~("cost .:;'~(
I First Appliance I $79.00
IFurnace/b.urner including ducts and vents
I Up to lOOk BTU/hr,
lOver lOOk BTUlhr,
I Heaters/stuves/vents
I Unit heater $17,00 I
I Wuod/pelletlgas stove/flue $38.00
I Repair/alter/add to heating appliance/ I
refrigeration unit or cooling system! $58.00 $
absorption system
I Evaporated cooler $13,00 I $
I Vent fan with one duct/appliance venl $9,00 I $
I Hood with exhaust and duct. $13,00 I $
I Floor furnace includLnKv~lJt ___ I...,.. '~nll' !'1\~$?!!:.QO.t! $
I Gas pipin'gl 1:'" IIV,", ':"'~:'.-:;'''::: .ha ",..nnri UH\~'l
lOne to fo;;r~~~tle!s~:",,'.:'::~:':-;:h-;"~" IU1eslstEl !$7,60 IU$
I Additio~ll(q@~i~;(i~f.li)~; ."001 0 throu ~h 0 \R 1l$4100~ 1 $
I Air-hai1cl,lihg -1:I_~n~,".i,I".I~I.~!Hng\duc.ts~S aT me I ~I\iI\,j w1
I up to 1 O:ii~i~f,~ the center. (NotEI:lne 1(~1~S:1!':9.0~1~ $
I Over 1O,0~Q.,t;:F.Mr for the Ure9?~ : ~~'~,I;~;$'2ii:6oi"$
I Comoressor/absof6iion IsvSfem~tiearoum'p.'.
I Up to 3 hpllOOk BTU I $17,00 I $
I Up to 15 hp/500k BTU $29,00 $
I Up to 30 hpll ,000 BTU I $43,00 $
I Up 10 50 hp/l,750 BTU I $57,00 $
lOver 50 hpll,750 BTU $95.00 I $
I Incinerators
1 Domestic incinerator .. $20.00 j $
I: Com'lil"erc iaI[r4~~~~:1~~1~i~~~~';t'{:~t~~~{.~,:S~~;?;i~~~~~r~~1f~;t~,~T~Y'~~{~~ii::~~:~7~~1
$
$17,00 I $
$20,00 $
$
$Se.
I Enter total valuation of mechanical sy~tem
and installation costs $ _ "
I Enter fee based on valuation of mechanical system. etc. $
I~M~';2:IT~1i;~ijt~1.fe't~~~~~~W~lit~11~~r~~#1!!ijit~ ~i~\I~.taIYLtl
,;........~:~.-:i',~""""'I..~~,-m';"':',~,~"....~.i;f::,"J:-'-~; $i:{J4~..'-,~.. ".'=..':""'~ ?.-i',1!;'ea::;-i%>m ;"!:'--,"';-cost:'i'''':'
I Reinspection . $58,00 $
I Specially requested inspections (per hr.) $58.00 $
I Regulated equipment (unclassed) I $13.00 $
Each additional inspectioo: (1) I $58.00 $ I
~~~~~~~i\~~e.R.~fcft:Nf~U5E~~~~
I (A) Enter subtotal of above fees (or enter set I
minimum fee of $ 79,00) $ 'lGJ
I (8) Investigative fee (equal 10 lAD $
I (C) Enter 12% surcharge (,12 x (A+BD $
I (D) Seismic fee, 1% (,01 x [AD $
I (E) Technology Fee (5% of [A]) $
1 TOTAL fees and surcharges (A through E): $
Status
Iss u ed
225 Fifth Street, Springfield, OR
541-726-3753 Phuue
541-726-3676 Fax
541-726-3769 Iuspectiun Line
SITE ADDRESS': 2248 9TH ST
ASSESSOR'S PARCEL NO.: 1703261201010
Springfield TYPE OF WORK: Pellet Stuve
TYPE OF USE: New
Residential
PROJECT DESCRIPTION: Pellet stuve in reesidence
Owner: DONNELLY AMY J
Address: 38885 JASPER LOWELL RD
FALL CREEK OR 97438
Phune Numher: 541-953-9188
I CONTRACTOR INFORMATION I
Contractor Type
Mechanical
Contractor License Expiration Date Phone
GOOD DEAL METAL PRODUCTS INC ,_~6743 08/2612010 541-736-9876
I ,BUILDING .INFORMATioN I!~:du;et~oln ~aw requires you to
NOt!tlcation Cent~. ~1'O~~~~I?regon Utility
# uf Sturies: In OAR 952-001-0010 tLot'Size-:S are set forth
. ""... nfC'1f'"l!; ,...^-o t'i'i)2
Height ufStructureO. You may obla/'n S,q Ft'lst'Fluur: ,001-
II' I.e(i'c.... (144-1...0 ""'Ie b
Type ufHeat: ca Ing the center (,SqF,f2na Flour: S y
b . "'I..;'~ T"t=! t,:;-.lt::ln~....
Water Type: num er for the Oreg,Sq,E,tIBasement.:one
VI' ~J I In, J\f()trt.-....+i,.,
Range Type: Center is 1.80 S.q, Ft _Garage/earport
v ::,!u.o::;: /,'\44.
Energy Path: Sq Ft Other:'
Sprinkled Building: nla Occupant Load: '
# uf Units:
Primary Occupancy Gruup:
Secuudary Occupancy Gruup:
Primary Cunstructiun Type
Secundary Cunstructiun Type:
# uf Bedruums:
I DEVELOPMENT INFORMATION I
REQUIRED PARKING
Fruntyard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Sular Setbacks:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% uf Lut Cuverage:
Tutal:
Handicapped:
Cumpact:
I/.I~-.--
.'ll'Wl'I'Uf...
THIS PERMIT S' I ~UBLlC IMPROVEMENTS I
,. .. - LALL ....", ".'- II 1111: VVUrlt\ '
Street Impruvements: ,.U I HOrRIZED UNDER THIS PERMIT IS N,oi Sidewalk Type:
Sturm Sewer Available:OMM"NCED OR IS ABANDONED FOR DuwnspuutslDrains:
Special Instructiuu:. ,NY 180 DAY PERIOD.
Nutes:
I ,Valuation Descriotion I
Descriptiun
Type uf Cunst~uctiun
. $ Per Sq Ft
or multiplier
Square Fuutage
ur Bid Amuuut
Value
Date Calculated
Pa2e 1 un
, Status
Issued
CITY OF SPRlNGFIELD .
Building/Combination Permit,
PERMIT NO: COM2009-01464
ISSUED: 10/0212009
APPLIED: 10/02/2009
. EXPIRES: 04/02/2010
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phuue
541-726-3676 Fax
541-726-3769 Inspectiuu Line,
Tutal Value uf Pruject
Fees Paid I
'1;,\
Fee Descriptiun
+ 12% State Surcharge
+ 5% Technulugy Fee
1st Appliance
Amuuut Paid
Date Paid
Receipt Number
$9.48
$3.95
$79.00
1012109
10/2/09
1012109
2200900000000001132
2200900000000001132
2200900000000001132
Tutal Amuunt Paid
$92.43
~l
I Plan Reviews ,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 same working day, inspections requested after 7:00 a.m. will be made the following
work day.
I Reo,uired 1I1snections I
Pellet Insert: After installatiun
By signature, I state and agree, that I have carefully examined the cumpleted applicatiun and do. hereby certify that all
infurmatiun hereun is true and currect, and I further certify that auy and all wurk.perfurmed shall be dune iu accurdance with
the Ordinances uftheCity uf Springfield and the Laws uf the State uf Oregun pertaining to. the wurk described herein, and
that NO OCCUPANCY will be made ufany structure withuut permissiuu ufthe Cummuuity Services Divisiun, Building Safety.
I further certify that unly cuntracturs andempluyees who. are iu cumpliauce with ORS 701.005 will be used un this pruject.
I further agree to. ensure that all required inspectiuns are requested at the pruper time, that each address is readable frum the
strcet, that the permit card is lucated at the frunt uf the pruperty, aud the appruved set uf plans will remain un the site at all
';~1r'"''''7JJ ~ 101 dloq
Owner ur ~Signature (
Date
Paee 2 uf2
22~ Fifth Street"
Springfield, Oregon.97477
541-726-3759 Phone
"-;.f
RECEIPT #:
Job/Journal NumbeJ:'::', ,: J~e~cr:iption. -_~
COM2009-01464 , ' ... ilstAppliance,
COM2009-,01464 . '.. ..+5% Technology Fee
COM2009-01464 :\;12% Stat~S"!:charge
':,
Payments:
Type of Payment
CreditCard
cReceiotl
Paid By
GOOD DEAL M~.']' {\L
PRODUCTS .
.i
\-
City of Springfield Official Receipt
Development Services Department
Public Works Department
,2200900000000001132
Date: 10/02/2009
Item Total:
Check Number Authorization
Received .8)' Batch Number Number How Received
KR 394925 In Persun
Payment Tutal:
Page I uf I
II :26:03AM
Amount Due
79,00
3,95
9.48
$92.43
Amount Paid
$92.43
$92.43
10/2/2009