HomeMy WebLinkAboutPermit Mechanical 2009-12-11
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Residential Mechanical Authorization To Begm Work
69600-BMC-09-00214
Approval Co~e: 07216D 12/11/2009 9:42 am
E.mailed To: kelly@comfortfiow.com
'I
I
City Of Springfield
225 Fifth 51
Springfield, OR 97477
Phone: 541-726-3753
Email: permitcenter@ci.springfield.or.us
1-0 New Construction IX] Addition/alteration/replacement
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001 or 2 family dwelling 0 Multi-family 0 Commercial 0 Accessory
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Job Address: 384 W D 5T
City/State/ZIP: SPRINGFIELD, OR 97477
I Suitelbldg.lapt.no.:
I Project Name: U-LRICH
Cross Street/directions to job site:
Tax map/parcel no.:
1703341401700
INSTAll DUCTLESS SYSTEM
Name: KATHLEEN ULRICH
Phone: 541-554-9932
Fax:
Email:
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I CCB lic. no.: 460
I Business Name: COMFORT FLOW HEATING CO
I Contact
I Address: 1951 DON ST
I City/State/ZIP: SPRINGFIELD, OR 97477~1993
I Phone: 5417260100 Fax: 5417264799
Email:
Metro lic. no.:
.City li,c. no.:
Upon review and approval' by yOtJr local jurisdiclion, your permit wjJJ be e-mailed
within one business day, with instructions on how to schedule your inspection.
or faxed
NOTE: This Authorization To Begin Work expires within 180 days if a permit is not obtilined.
The local building department may determine that an Authorization To Begin Work is' null and
void if it does not meel applicable land use laws and local ordinances.
~LU\)ct -' Ol7CcF7
n n\ IvV I t /0 01
Description J Qty. l Ea. I Total
IH~~ti-,"lg/.~9(nL~g~!\ppli~inl;e-S-~';,JJ}~:::?r~~~~~'~~~~~~~t ~,~'.
I Heal Pump
! First Appliance Fee
I Subtotal
State surcharge (12% of permit
tolal)
Technology fee (5% of permit total)
I TOTAL PERMIT FEE
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~\Y f"\'
~~
$79 00 I
"tl
$96.00 I
$11521
$480 I
$112.321
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Inspections Phone: 541.726.3769
This Authorization To Begin Work must be posted at the job site until replaced by a Permit
Status
Issued
CITY OF SPRINGJ'lELD
Building/Combination Permit
PERMIT NO: COM2009-01767
ISSUED: 12/11/2009
APPLIED: 12!J 1/2009
EXPIRES: 06/] 1/2010
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 384 W D ST
ASSESSOR'S PARCEL NO.: 1703341401700
Springfield TYPE OF WORK: Mechanical Only
TYPE OF USE: New
Residential
PROJECT DESCRIPTION: Install ductless system
Owner: ULRICH KATHLEEN
Address: 384 W D ST
SPRINGFIELD OR 97477
I CO,NTI~CTOR INFORMATION I
Contr'actor Type
Mechanical
. Contractor
COMFORT FLOW HEATING CO,
License
460
Expiration Date
06/27/2011
Phone
541-726-0100
l ~U1LDlNG INFORMATION.
# of Units:
Primary Occupancy Group:
Secondary Occnpancy GronlJ:
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 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load: .
nla
I DEVELOPMENT INFORMATION I
Front yard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
REQUIRED PARKING
Total:
Handicapped:
Compact:
'. ....(.
I PUBLIC lMPI,WV,EMEN,!S I
Street Improvements:
Sidewalk Type:
ATI6MTlIS\liuQVWliOt!;lW requires you to
follow rules adopted by the Oregon Utility
Notification Center. Those rules are set forth
in OAR 952-001-0010 through OAR 952-001-
0090, You may obtain copies of lhe rules by
,,~bt:. ' \F II\' ';'_" 'n'~ !:tr:::.;; r-._ ..-..:..... S\'-'~..... .;,<;; Lvl"'JJIIUII~
~S' PERMIT SHAll EXPIRE RMrr ~al'<ion DescriDtion I number for the. Oregon Utility Nolification
IZED UNDER lHIS PE , , , , Center IS 1-800-332-2344).
,IJTHOR NDONED FOH
, ':. NC:~" Q,P IS ABA , $ Per Sq Ft Square Footage
Descl'lptlOnJ\ME \T,vpe t'Con~trnetIOJI I' I' B'd A
v'" 80 DA" PER IOU , or mn tIp ler or I mount
ANY i " .
Storm Sewer Available:
Spechtllnstruction:
Notes:
Value
Date Calculated
Page 1 on
Status
Issued
CITY OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO: COM2009-01767
ISSUED: 12/1112009
APPLIED: 12/11/2009
EXPIRES: 06/11/2010
VALUE:
225 Fifth Strcet, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Total Value of Project
Fees Paid I
Fee Description
+ 12% Statc Surcharge
+ 5% Technology Fee
1st Appliance
Heat Pump
Amount Paid
Date Paid
Receipt Number
$11.52
$4.80
$79,00
$17,00
12/11/09
12/11/09
12111/09
12111/09
3200900000000000803
3200900000000000803
3200900000000000803
3200900000000000803
Total Amount Paid
$112,32
I Plan Reviews ,
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 , ~eo~,ired.I,~~n~~t,io,n~ I
Rough Mechanical: Prior to Cover
Final Mechanical: When all mechanical work is complete.
By signaturc, 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 a~cordallce with
the Ordinanees 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 madc of any structure without permission of the Community Serviees Division, Bnilding Safety.
I fnrther certify that only contractors and employees who arc 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 proptJ" 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 construction. .
Owner or Contractors Signature
Date
Page 2 of2
225 Fifth Street
Springfield, Oregon '97477
541-726-3759 Phone
Job/Journal Number
C.oM2009-0 1767
C.oM2009-0 J 767
C.oM2009-0 1767
C.oM2009-0] 767
Payments:
TYlll' of Payment
.oNLINE CHGS
cRcceintl
RECEIPT #:
Description
1st Appliance
He~t Pump
+ 5% Technology Fce
+ 12% State Surcharge
Paid By
.oNLINE PERMIT CHGS
City of Springfield Official Receipt
Development Serviccs Department
Public Works Department
3200900000000000803
Date: 12/11/2009
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
njm
.oNLINE comfort flow .online
Payment Total:
Page 1 of]
I :37:57PM
Amount Due
79,00
17,00
480
11,52
$112,32
Amount Paid
$112,32
$112,32
12/1 ]/2009