Loading...
HomeMy WebLinkAboutPermit Mechanical 2009-10-20 Ili'itJ,:)rD'EPAR~,lME',NT'fU,'SE,'r,b,'"r:{~y,l'0)rwl r'~:~~;;';"...I;..',.,.,,",.':t':;,:::~;:31h:,,,, '~"'f",,,,~:;l~,,,:;! C\i,.~~;, :>":;'-J.<.i. ",::f~"N~*~J: I Permit no:??; - Is-) C. I I Date 1/1 /J-tJ /0 7 I Mecha'iHcal Permit Application 225 F;fth Street. Spnngfield, OR 97477 . PH(541)726.J75J . FAX(541)726.J689 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. ' l~y~~f~i~!f:~S~:~t0~G~ITr~G'9.f{~~Q'~fgQ~$TRP.9Ji.Q.N.~~;t~~f:~~F''';'~ -':~I .'!,::{:~"'~:::~'~: "'-;-~;~'lf:;"i.f"F'~E "'SCH epti LE" '..~ : c ~--'!.';~': ~-'.:'. '.' :': '.'. ':1 I D Residential I D Government I D Commercial I I~Riig(d~"hli~I;l;>;)~j!~i~t~;;;;#&i$i'~~:~liil!Qif:I~~qi!1\i}: ,);~~!al,iit-;I 1"';F";;'i'rns't':~A"P:"':P''2:I''i'a~'.n'''-l:c''e'~'~~,~l'f/j~~~f.ih.(!j:,~';f,Ji;1:,{,;",;ift! j""'Lx ,~(: l~$' '~7ge.aO'O'''!':''''''';':~ ~$:#.Jc;!,s~t{;~~""1 ." 1~1.rr(~jQ~~~lmE:~Ii:'i~'QRMN!lliiN[~NP1~iEQ~;jjlQ'NMii:2:iiII:I 'f - - I Job site adaress: /.2 oY. #A:;/J11 t-7ZJ' /\.J IFurnace/burner including ducts and vents I City: /S's1:Hj) I State:,,'lJt- I ZIP: '/'7'(.)1'; I Up to lOOk BTU/hr. I I I Reference: \nO.:z. 0:1."'- 'lf2-, I Taxlot.Jm~, I lOver lOOk BTU/hr, "I 'L.lo.J""\ V\.j.... I Heaters/stoves/vents l'f;;5E~CRIPo,Ti.QN"()FWQRK'-:i.'::'''T,;'? ~'.F I I Unit heater 1/./C'1J C; It')' F?: i c 1\-.5 i-itv",'- I I Wood/pellet/gas stovelflue ~ '\ . . I Repair/alter/ad dt 0 heating appliance/ refrigeration unit or cooling system! ~~!~lk~?~~~~~~t;iPR~0RERTi't~0V\iN'ER~rj~~1re~!~W~:~:r~~ absorption system t",.~~~~-"",;,;,.f.)i~t'&;>2~."j"".."", iL_.".......c.. i,~.....,,-,~._..__.!tiL_.,__,ftF!,,, __.~,.",~:t.:Cfty, I Name: f::;/vrIVZ-cIT. 1:I:-Di2e-v <;! ,,};1'/Vc'-- I I Evaporated cooler I Address: /..z-f "1' /7'/4"""1 t--7'ZJ,A.../ I, I Vent fan with one duct/appliance vent -I Hood with exhaust and duct I City: s.p Pz-- I State: 6"L I ZIP: '1 '7'-r?'! I I Floor furnace including vent Phone:-:,"Vs" -/S-OG I Fax: I I Gas,piping E-mail: I lOne to four outlets I I This installation is being made on property owned by me or a I Additional outlets (each) member of my immediate family, and is exempt from licensing I Air-handlingunits, including ducts requirements under ORS 701.010, ' I Up to 10,000 CFM I I $11,00 I $ Signature: lOver 10,000 CFM $20,00 $ 1.~~~llt~'i(~\~C0Nj;RACm0R~iNstj:l;IlIfAfj0N~~;S~~:~~"i'l I Compressor/absorption system/heat pump I"'~:~:~:'::~~ ~=-~; "=:-;; '~~:-.;-~~;;;;;~' ';;H ~: :: ~ 5h~~~~~~:;~u I ::::~~ I ~ I Address: !.r.t;) 1I;.1-r"'1 ~i'7);"/ " I I Up to 30 hp/! ,000 BTU ' $43,00 $ I City: .:.> f' Pt.-/) I Statetj;,L. I ZIP: "77/?, I I Up to 50 hpll,750 BTU $57,00 $ ,II Phone: "7'5''1'- lI? Je..-.. I Fax: 'I lOver 50 hp/I,750 BTU $95,00 $ (I E-mail:" I Ilncinerators I' "77 ., I Domestic incinerator $20.00 I $ CCB !tcense no,: '(., ~ ( I Print name:. tt'4J<?.fi? E:'/JU db/oj I I Enter total valuation of mechanical system 1\ / / / ,j / L I and installation costs $ - . ~ignature: ! 1i7!Jt. fifiA . I Enter fee based on valuation of mechanical system, etc. I $ L U' fV''Ti't<::-'r'' ~ Ir~i~~~~~~g~~jf~~1~jiU~~~Wf~I!~!T.1'I~~1~!1'~~~~~~~~;'~ ~ ' I Specially requested inspections (per hr.) $58,00 $ ~ cf\. I Regulated equipment (unclassed) $13.00 $ ~ ~:b\~ \~~ i~~~~~~t.~'~i ~ I (B) Investigative fee (equal to [A]) $ I I (C) Enter 12% surcharge (.12 x [A+B]) $ 10 -~."" I (D) Seismic fee, 1% (.01 x [A]) $ . I (E) Technology Fee (5% of[A]) $ ~ 'j C I TOTAL fees and surcharges (A through E): $/OO'Y- $17,00 I $ $20,00 I $ $17,00 $38,00 $ $ $58,00 $ $13,00 $ $9,00 $ $13,00 $ $58,00 $ $7,00 I $4,00 $ '1 $ 440.2545.) (lli08/COM) , :~ Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2009-01536 ISSUED: 10/20/2009 APPLIED: ]0/20/2009 EXPIRES: 04/20/20]0 VALUE: 225 Fifth Street, Springfield, OR' 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 1284 HAMILTON ST ASSESSOR'S PARCEL NO.: 1703342200223 Springfield TYPE OF WORK: Mechanical Only , '".TYPE OF USE: New PROJECT DESCRIPTION: zero-clearance gas fireplace and gas line Residential Owner: Address: EMMETT ANDREW E & JANE E 1284 HAMIL TON ST A!TENTION: Oregon law requIres you to SPRINGFIELD OR ~~+~_~~I:l!. adopte3 by the Oregon Uti/iN ," . --_.. --..."".. \IIV';'C'lu't/~i:lreSettorth 10 OAR9~2~1b1>6!Rlfi\I~ORMAJD~N I 0090,. You II-'~V1H1V' _!/!_U.r.nr.J~ u calling the center. (Note: the tele h 1 : ContractllJinber for the .o~~9.Qn_U,ti1 'litM~lit flI@ense AMERICAN GAeeM'~~~_~lN'~'11 I BUILDING INFORMATION I Expiration Date 10/3112010 Phone 541-954-4686 Contractor Type Mechanical # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type S~condary Construction Type: # of Bedrooms: R3 # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: VB Front yard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: NOTICE: I HI~ 'll.fflWE~~~~RMAA'~ AUTHO'lt.!.x uMJD'f Ih{b ~~"l~l/r u,".HJf COMMENCED ,qtU~..MM'lDONED FOR ANY 180 DAY ff~.@iree~ Rqd: Paved Drive Rqd::, " , .% nfLot Coverage:' No REQUIRED PARKING Total: Handicapped: Compact: ,'.!...... I PUBLIC IMPROVEMENTS I, Street Improvements: Storm Sewer Available: Special Instruction: , Sidewalk Type: DownspoutslDrains: Notes: I V al~ation Descriotion I Description Type of Construction $ Per Sq Ft or multiplier ' Square Footage or Bid Amount Value Date Calculated Page I 00 ' -~r~!~~~!::~.~~t.;.~:y Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2009-01536 ISSUED: 10120/2009 APPLIED: ]0/20/2009 EXPIRES: 04/20/20]0 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line , ,., .. . Total Value of Project Fees PaiclJ Fee Description + 12 % State Surcharge + 5% Technology Fee 1st Appliance Gas Outlets 1-4 Amount Paid Date Paid Receipt Number $10.32 $4.30 $79.00 $7.00 10/20/09 10/20/09 10/20/09 10/20/09 1200900000000001163 1200900000000001163 1200900000000001163 1200900000000001163 Total Amount Paid $100.62 I Plan Reviews I To Request an inspection call the 24 hour recording at726-3769. 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. R.er,uired Insoections I Rough Gas: After line is installed and required testing and capped if not attached to an appliance. Rough Mechanical: Prior to Cover Final Gas: When all gas work is complete. Final Mechanical: When all mechanical work is complete. By signature, I state and agree, that I have carefully examined the completed application and do hereby certify that all information hereon, is true and correct, and I 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 Services Division, Building SafetY. I further certify that only 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 '""';XtlA IN=9 Owner or Contractors Signature Date '- Page 2 of 2 225 Fifth Street Springfield, Oregon'97477~-~'--' m 541-726-3759 Phone Job/Journal Number COM2009-01536 COM2009-01536 COM2009-01536 COM2009-01536 Payments: , Type of Payment Check cReceintl RECEIPT #: Description . "1st Appliance \ Gas Outlets 1-4 :+ 5% Technology Fee + 12% State ,Surcharge Paid By AMERICAN GAS APPL SVS ~ ,: City of Springfield Official Receipt Development Services Department Public Works Department 120090000000000]163 Date: ]0/20/2009 Item Total: Check Number Authorization Received By Batch Number Number How Received CJc 6375 In Person Payment Total: Page 1 of I 10:48:28AM Amount Due 79,00 7,00 4,30 10.32 $100.62 Amount Paid, $100,62 $100.62 10120/2009