HomeMy WebLinkAboutPermit Mechanical 2009-9-29
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'City uf Springfield
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Mechanical Authurizatiun To. Begin Wurk
E-mailedTo:brand)..@associatedheating.com
69600-BMC-09-00138
9128/2009 4:22 pm
Approval Code:.OI4Q03
Check on status of permit
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": :~r P,ho~e: 541-726-3753 or Email: permitcenter@ci.springfield.or.us
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Appliance Fee
Total
I..D NcwConstructlon 0 ~ddinonlalterationlrep]acement
. I~AfEG'oRY16Flco-NsiR(.ICTION~~~~~~~~t&:
10'm 2 '''''''y dwd"", [j M,It;.iw~II;":.. tJ c,mm"';~ DA"""O' B,lId'"
Il~,"",,~':!l;[ly_,UOBfSiTEiINEORMATloNe,;:NiiiUOCATloN~~~!:i'W~~51
I Job Address: 521 67THST I Subtotal $96.00
, I State surcharge (12% ofpwnit $/1.521
I City/StateJZIP:-SPRI"N"GF.IELD, pR ,?7478 .' .:;:. total) ~
I Suite/bldg.lapt.no.: ',I, ;' -: I ITechnoJogy tee (5% ofpermil $4.801
total)
'. I Proj<<t Name: I I TOTAL PERMIT FEE 5112.321
I C,"" SMd,,,,non' to job "to: I _ k':JL q I ~,/Cf1 .
I T" m'plp.,," "'.: I t 9 I tf4 tf .
Description
Heat Pump
Install HIP system
!"
I Name: Debra kelly
I Phone: 541-654-0115
I Email:
Fax:
ATTENTION: Oregon law requires you to
follow rules adopted by the Oregon Utility
Notification Center. Those rules are set forth
in OAR 952"001-001 0 through OAR 952.001-
0090. You may obtain copies of the rules by
calling the center. (Note: the telephone
number for the Oregon Utility Notification
Center is 1-800-332-2344),
I cCBH<,DO,: 1062~5JnTIr.E~
I Business Name: ASSOCIA TED"HEft. TING '& 'AIR (6)NI'if'l'lbilil../G IJJlC TH E W 0 R K
. 1111,1 I (lllVIl t ullru_L: 1:/" Y'i",'.::: H'
I Coot"" AilTHORI7FD UNDER THIS PERMIT I~ NUl
IAdd"'''POBOX1\t1M~flFNr.FO OR IS ABANDONED FOR
I City/State/ZIP: EUg~;t~: O,~;~141~ A Y PER I 0 D.
I Phone: 54]-683-2590 Fax: 541-607-0287
I Email:
I Metro lit. 00.:
City lit. no~:
NOTE: This Authorization To Begin Work expires within 180 days if a penn it is
not obtained"
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Upon review and approval by your local jurisdiction, your pannit will be
e-mailed or faxed within one business day; with instructions on how to
schedule your inspection.
The local building department may detennine that an Authorization To Begin
Work is null and void if it does not meet applicable land use laws and local
ordinances
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This Authorization To Begin Work must be posted at the job site until replaced by a Permi~
Status
Issued
CITY OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO: €OM2009-01444
ISSUED: 09/29/2009
APPLIED: 09/28/2009
EXPIRES: 03/29/2010
VALUE:
225 Fifth Street, Spr,Ingfield, OR '.
, 541-726-3753 PhuDe'
541-726-3676 Fax
541-726-3769 In"spectiun Line
SITE ADDRESS: 521 67TH ST
ASSESSOR'S PARCEL NO.: 1702341403735
Springfield TYPE OF WORK: Heating System
TYPE OF USE: New
Residential
.,
PROJECT DESCRIPTION:' Install heat pump in residence
Owner:
Address:
KELLY DEBRA L
521 N 67TH ST '
SPRINGFIELD OR 97478
Phune'Number: 541-654-0115
I CONTRACTOR INFORMATION.
Contractor Type
Electrical
Mechanical
, Contractor
OREGON ELECTRIC SERVICE
ASSOCIATED HEATING & AIR CONDITIO
License
181997
106275
Expiration Date
" 05/09/2010
08/31/2010
Phone
541-343-1681
541-683-2590
BUILDING INFORMATION.
# uf Units:
Primary Occupancy Gruup:
Secundary Occupancy Gruup:
Primary Cunstructiun Type
Secundary Cunstructiun Type:
# uf Bedruums:
# uf Sturies:
Height uf Structure
Type uf Heat:
Water Type:
Range Type:
Energy Path:
Sprinkled Building:
Lut Size:
Sq Ft 1 st Fluur:
Sq Ft 2nd Fluur:
Sq Ft Basement:
Sq Ft Garage/Carpurt
Sq Ft Other:
Occupant Luad:
n/a
I DEVELOPMENT INFORMATION.
REQUIRED PARKING
Nutes:
Fruntyard Setback: Overlay Dist:
Side 1 Setback: # Street Trees Rqd:
Side 2 Setback:NOTICE: Paved Drive Rqd:
Rearyard Setb:\i;Ii;S' PERMIT SHALL EXPIRE IF TP1oEu'I\If;'<\1\r;:uverage:
Sular Setbacks;~UTHORfZEO UNDER THIS PERMIT IS NOT
vUIVIIVICI~vCU un I;) I'.DI'.I~' .. ","-" ~. .-
ANY 180 DAY PERIOD. ' IPUBLlC IMPROVEMENTS IATTENTION: Oregon law requires you to
Street Improvements: follovSid~waIRCType:j by the Oregon Utility
Notification Center. Those rules are set forth
in OAfP9:lYJI~p"u"~LIlra.i~.s~ugh OAR 952.001-
0090, You may obtain copies of the rules by
calling the center. (Note: the telephone
number for the Oregon Utility Notification
Center is 1.800.332-2344).
Tutal:
Handicapped:
Cumpact:
Sturm Sewer Available:
Special Instructiun:
Page 1 uf3
Status
Issued
225 Fifth Street, Spriugfield, OR
541-726-3753 Phune
541-726-3676 Fax
541-726-3769 Inspec,tiun Line
-"i.-", "
I Vahlation Descrintion I
Description
Type uf Cuustructiun
. $ Per Sq Ft
ur multiplier
Fee Descriptiun
+ 12% State Surcharge
+ 12% State Surcharge
+ 5% Technulugy Fee
+ 5% Technulugy Fee
1st Appliauce
Add, Alter, Exteud Circ
Add, Alter, Extend Circ Ea Add
Heat Pump
Amuunt Paid
$8.76
$11.52
$3.65
$4.80
$79.00
$55.00
$18.00
$17.00
Tutal Amuunt Paid
$197.73
Square Fuutage
ur Bid Amuunt
Tutal Value uf Pruject
Fees Paid I
Date Paid
9/29/09
9/29/09
9/29/09
9/29/09
9/29/09
9/29/09
9/29/09
9/29/09
I Plan Reviews I
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2009-0I444
ISSUED: 09/29/2009
APPLIED: 09/28/2009
EXPIRES: 03/29/2010
VALUE:
Value
Date Calculated
Receipt Number
2200900000000001106
22~0900000000001105
2200900000000001106
2200900000000001105
2200900000000001105
2200900000000001106
2200900000000001106
2200900000000001105
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 R'i'l',lir~d, r~s~e~ti~~~J
Ruugh Mechauical: Priur to. Cuver
.' .
Final Mechanical: When all mechanical wurk is cumpJete.
Ruugh Electric: Priur to. Cuver
Final Electric: When all electrical wurk is cumplete.
Paee 2 uf 3
Status
Issued
CITY VI' ~PRINGFIELD'
Building/Combination Permit
PERMIT NO: COM2009-01444
ISSUED: 09/29/2009
APPLIED: 09/28/2009
EXPIRES: 03/29/2010
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phune
541-726-3676 Fax ':
541-726-3769 Inspectiun Line
By signature, 1 state and agree, that.I have carefully examined the cumpleted applicatiun and do. hereby certify that all
. infurmatiun hereuil is true aud currect, aud I further certify that any and all wurk perfurmed shall be dune in accurdance with
the Ordinances uf the City uf Springfield and the Laws of the State uf Oregun pertaining to. the wurk described hereiu, and
that NO OCCUPANCY will be made uf any structure withuut permissiun uf the Cummunity Services Divisiun, Building Safety.
I further certify that unly cuntracturs aud empluyees who. are iu cumpliance with ORS 701.005 will be used un this pruject.
I further agree \0. ensure 'that all required inspectiuns are requested at the pruper time, that each address is readable frum the
street, that thepermit card is lucated at the frunt uf the pruperty, and the appruved set uf plans will remaiu un the site at all
times during cunstructiun.
Owner ur Cuntracturs Signature
Date
'.
,
!'
Paee 3 uf3
225 Fifth Street,','. c. '
Springfield, Oregon 97477 > ,.
'541-726-3759 Phone,
RECEIPT #:
Job/Journal Number :.;>;.
COM2009-01444 ;'
C01'12009-01444 ".
COM2009-01444 ..'\:
COM2009-0] 444
Descriptio~. .....
"lst'Appliance
. Heat Pump
'+.5% Tech!,ulu~y Fee .
+ ]2% State Surcharge
Payments:
Type of Payment
Paid By ,
ONLINE CHGS "ONLINE PERMIT CHGS
cReceiotl
2200900000000001105
City of Springfield Official Receipt
Development Services Department
Public Works Department
Date: 09/29/2009
Item Total:
Check Number Authorization
Received By Batch Number Number How:Received
KR
Page I of I,
ONLINEASSOCIA T Online
ED
HEATING
Payment Tutal:
9:40:06AM
Amount Due
79,00
17,00
4,80
11.52
$112.32
Amount Paid
'.
$112,32
$112.32
9/29/2009