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Home My WebLink AboutPermit Mechanical 2009-12-8 CITY OF SPRINGFIELD' . Building/Combination Permit 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line . . (~ PERMIT NO: COM2009-01745 ISSUED: 12/08/2009 APPLIED: 12/08/2009 EXPIRES: 06/08/2010 VALUE: Status Issued SITE ADDRESS: '3904 NORTH ST Springfield TYPE OF WORK, Wood Stove ASSESSOR'S PARCEL NO" 180~l!llfrl@:lN: Oregon law requires you to follow rules adopted by the Oregon OtilllJ OF USE: New PROJECT DESCRIPTION: Ne>mgm!~Center, Those rules are seHorth in OAR 952-001-001 0 through OAR 952~1. 0090. YOU may ODlaUl l.;UiJll;;i:!i VI ,ltCI' IUtVOllll BOGGlE STAN W & L&.M~\ft!fe center, (Note: the telephone 3904 NORTH ST. .number for the Oregon Utility Notification SPRINGFIELD OR 9747~ . Center Ie 1-800-332-2344). Residential Owner: Address: I ,CONTRACTOR INFORMATION I Contractor Type Mechanical Contractor GOOD DEAL METAL PRODUCTS INC' .". ::....",;'l'"{""r" License 26743 1" Expiration Date 08/26/2010 Phone 541-736-9876 # of Unit" Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Constrnction Type: # of Bedrooms: I BUILDING INFOR~ATlON I NOTlCW:OfSt~ri~s: ' Lot Size: R-3 THIS PEAfu,\!i'itS.H~drhcltO'JeIRE IFTHE WORKSq FIlst Floor: AUTHOP!li:i!{loVHOOR THIS PERMIT IS NOT Sq Ft 2nd Floor: VBCOMMEWe'~.tfUW's ABANDONED FOR Sq Ft Basement: ANY 18(~lY'i-lIie P.~l!tlbD. . ' Sq Ft Garage/Carport "Energy r-aih: Sq Ft Other: Sprinkled Bnilding: No Occupant Load: I DEVELOPMENTlNFORMATION I REQUIRED PARKING Front yard Setback: Side J Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: O;{) of Lot Coverage: Total: Handicapped: Compact' I PUBLIC IMPROVEMENTS ~ . Street Improv.ements: Storm Sewer Available: Special Instruction: Sidewalk Type: DownspoutslDrains: Notes: I Valuation Descriotion I DescriPtion Type of Construction $' Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Paee 1 01'2 Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2009-0I745 ISSUED: 12/08/2009 APPLIED: 12/08/2009 :EXPIRES: 06/08/2010 VALUE: 225 Fifth Street, Springfield, OR 541-726~3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Total Value of Project Fees P~id ,I 'Fee Description + 12% State Surcharge + 5% Technology Fce I st Appliance Amonnt Paid Date Paid Receipt Number $9.48 $3,95 $79,00 12/8/09 12/8/09 1218/09 .. 2200900000000001356 2200900000000001356 2200900000000001356 Total Amount Paid $92.43 Plan Reviews I To Request an inspection call the 24 hour recording at 726-3769. All inspections requested before 7:00 a,m, will be made the same working day, inspections requested after 7:00 a,m. will be made the following work day. Rf~uired 'ns'P~ctio!,sl Wood Stove: After Installation, By signature, I state and agree, that I have carefully examined the comllleted "pplication and do hereby certify tbat all information hereon is true and correct, and I further certify that any and all work performed shall be done in accordance with the Ordinances of the City of Springfield and the Laws of the State of Oregon pertaining to the work described herein, and that NO OCCUPANCY will be made of any structure without permission of the Community Services Division, Building Safety. I further certify that only contractors and employees who are in compliance with ORS 701.005 will be used on this project. I further agree to ensure that all're<}\,ired inspections are requested at the proper time, that each address is readable from. the street, that the permit card !s'i~safed at the front of the property, and the approved set of plans will remain on the site at all times during construction.,{.....-..... '/- ~'~~c7. ;1 h /-. ...\? :;/'y_______si 07/ If /0 9 ~~.- / ~/ Owner or Contractors Sig2!!_wre / I /' Date , , Page 2 01'2 Mf;chanical Permit Application It~g~~1~:~t~~~~M:~EIi:Q:~:~!~E:~~~j~ I Pennitno: {}Cj-/'7y S- - I Date: I 2 / '3/ () cr 22~ FIfth Street. Springfield, OR 97477 . PH(541}726.3753 . FAX(541)726~3689 This permit is issued under OAR 918-440-0050. Permits expire if work is not started within 180 days of issuance or if work is suspended for 180 days.) 1~~~;~;1~:;~?;t~1,t:mG'l\~~q'O',RY~{~i~~Q'QN$j!~Q"GJJ1Q.N_W~i'~~,:~~;'~~x;:r~'~'\ :~;' _,f'Residential I 0 Government I 0 Commercial ~€~'JOB\1'SlmEi!iINE0RMA:j;jO ..fANDlt[i'CAmj0Ni:;1lfi;;iG~if .~.,,,.,,,..L'-,,,,,,, .;,_ .'_ ..I1L..,,,,,.,-. J:.. .,1'.~ _~',._n,__."_,_".,_._,..J'I,,.L.._._.,..._...,Jf'; ~'''_'_'_''':d.....".""L..,w",~)!},.+ I Job site address: "J 9,01- 1/od/' -::liJ <-"'-'!.t; I I City") f7C //I'j1:/.fJ U I State~ I ZIP:77J/7:r I I Referel:ce: I Taxlo!.: I I. .~7 ~sl;/o));:ti7:~~~';;~:~;:;C ~:FI I ~~~~"tliifli~RR.~~i;RJ::'(~[Q'l'iH~,R~\i!~]$;~~~i,';~1 IName :')/'oJi ('J~c;j",- I / I I Address:.3101.uvM'1{;';- SifT'-/' b I I City 5ot/.,.<; {;'.(J[)! I State ole' r ZIP: 'fJ.v7?f I 1 -. I PhoneI54f-7:<-9 - ';/0;)(, I Fax: / -/ I I E-mail 5c....Jlnd...IJcCV77CC;..!hP.fl 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 701.010, Signature: 1i'/iij~t;illci.;;~~tI"C'0Nt'RAe:t'0R";INSFAiIlTAfiiION~~\"';:::'Ii\%1@i~\\';111 gg..,_,,.';~....~B:l:.~__.._.,..~.., ,_'...' ... '0,-,.,0;- _.' .~.._.._....,.;'.~_.,..._"......._...L"'Wd"......,,'if ~'""". ..,"->>..' "-'",_,,""''-.'' I Business name: (.,cJ D l) I~~L- I I Address: c:,- ~ .'-;, '2- /VIA-/ i./ I I City: <; P Fi-.0 I State I ZIP: I Phone '71(.,- '1074 I Fax I E-mail: I CCB license no,: 'J-v 7 LJ 3 1_ Print name: I Signature: I ,,&\J~d\rv \~l:7~ \fr 440-2545-) (J il08/COM) I"'\';"~,~C',;;; ?""':'::^FEE' S(jHEOULE,' '.;;;";'!',,:;.' "",t "'\"'1 I~R~~Yd~1{ti~I/l;3!;<'t~~~~,lli'\4'\"~!~~:>>'l!:c;:ifI'Qi9;ilf;"9&J;ii~1 ,~,r,?!al~HI I %~~\;~';:~~;-'i-;~~;~E:!~~1~f.St11.jt~"/H",:-~~,,~goJ f&'I'_"'J ~;~~~~~~<: I %<:~;st:!J'; I ~urnace/burner including ducts and, vents 1 I Up to lOOk BW/hr, I I $17,00 I $ 1 lOver iOOk BTU/hr, $20.00 $ I I Heaters/stoves/vents I I Unit heater $17,00 $ I 1 Wood/pellet/gas stovelflue $38,00 $ I Repair/alter/ad,."d to heatingappliancel refrigeration unit or cooling system! $58.00 $ absorption system I. Evaporated c09ler - $13.00 $ I I Vent fan with one duct/appliance vent $9,00 $ 1 1 Hood with exhaust and duct $13,00 $ 1 I Floor furnace including vent $58,00 $ I I Gas piping I I. One to four outlets I I $7,00 I $ 1 Additional outlets (each) $4,00 $ 1 Air-handling units, including ducts 1 Up to iO,OOO CCFM I I $11,00 I $ I Over j 0.000 CFM $20,00 $ I Compressor/absorption system/heat pump I Up to 3 hp/I OOk BTU $17,00 $ 1 Up to 15 hp/500k BTU $29,00 $ I Up to 30 hp/i,OOO BTU $43,00 $ I Up to 50 hp/I ,.750 BTU $57.00 $ I Over 50 hp/i,750 BTU $95,00 $ I' Incinerators I Domestic incinerator ,j $20.00 J $ I 0C'omm(ffc_IJil~~~~'1}1~~~{~%~q1;[FZ:~~'~0r::~~.(1W~~~f,0~)~/f:~;,~r~~j~T:>3:1 Enter total val~ation of mechanical system , and installation costs $ , 1 Enter fee based on valuation of mechanical system, etc, $ I~ M'o'~"'f...~If~~'H_~a~tf;';;<:'Ci.~%f;'~l~.-rS-~~~'7It~~;~Ir&,;!COSfi'~~ ~)J'.Tot81,"~~; fb''IJ~E;1~~~lt~2M!"\.~'~r~;i~'flt~~ ~,~f'l~~ ~!~r/ea~i;W; ~~?C({st[,t} I Reinspection " $58,00 I $ I I Specially requested inspections (per hr,) I $58,00 $ 1 I Regulated equipment (unclassed) 1 $13,00 I $ . 1 I Each additional inspection: (I) I $58,00 $ I 1~~t~~11~'l~i1fA-~:~rri.C~N_f~~U__sE't~~~l~~tf~~ I, (A) Enter SUbto,. tal of above fees (or enter set '70] l' minimum fee of $ 79,00). $ ( . 1 (B) Investigative fee (equal to [A]) $ 1 1 (C) Enter j2%,surcharge (.12 x [MB]) $ ') ~. I. I (D)Seismidee.j%(,Ojx[A]) $ I' I (E) Technology Fee (5% of[A]) $ J ?5=.."j I TOTAL fees,and surcharges (A through E): $ t} J- '-121- 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone 4l:.'.'~'.'.~_--~'';' ".."'" ..C........ iL' , . . . ~ . ~" ~ . , - . . .. .~ ~ -- .~.,-......,;,- ,."......- .". . . City of Springfield Official Receipt Development Services Department Public Works Department RECEIPT #: 2200900000000001356 Date: 12/08/2009 9:48:ISAM Job/Journlll Number Description Amount ()ue COM2009-0 1745 I st Appliance 79,00 COM2009-0 1745 + 5% Technology Fee 3,95 COM2009-0 1745 + 12% State Surcharge 9A8 Item Total: $92.43 Payments: Check Number Authorization Type of Payment Paid By Received By Batch Number I Number How Received Amount Paid Cash STAN BOGGlE cJc In Person $ j 00,00 Change In Person ($7,57) Payment Total: $92.43 Job/Journal Number Description Amount Due COM2009-0 J 745 I sl Appliance 79,00 COM2009-0 1745 + 5% Technology Fee 3.95 COM2009-0 1745 + 12% State Surcharge 9A8 Item Total: $92.43 Payments: Check Number :" Authorization Type of Payment Paid By Received By Batch Number Number How Received Amount Paid Cash STAN BOGGlE cjc In Person $100,00 Change In Person ($7.57) Payment Total: $92.43 cReceintl Page I of 1 12/8/2009