HomeMy WebLinkAboutPermit Mechanical 2009-12-10
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City Of Springfield
225 Fifth 51
Springfield, OR 97477
Phone: 541-726-3753
Email: permilcenler@cLspringfield.or.us
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Residential Mechanical Authorization To Begin Work
69600-BMC-09-00210
Approval Code: 097509 12/10/2009 9:17 am
E.mailed To: erogers1976@aol.com
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I Description I Qty, I
IrJlinim_l1rri:F:ees'::f~~:l;<'h i..;i:;~;' '-~,
I First Appliance Fee
1:::~~ical'~ermit.F,.eS"f':;~
1 Slate surcharge (12% of permit
total)
I Technology fee (5% of permillolal)
I TOTAL PERMIT FEE
Ea.
, ,I
Total I
1
$79.00 I
'I
$79.00 I
$9.481
$3.95 I
$92.43 I
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D New Construction
IKI Addition/alterationlreplacemenl
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IKJ 1 or 2 family dwelling 0 Multi-family D Commercial 0 Accessory
>C" ," JOSSITE irilE6RiinATIOril'ANDll6c~;TrON
I Job Address: 2750 VILLA WAY
City/State/ZIP: SPRINGFIELD, OR 97477
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Suite/bldg./apt.no,:
Project Name: Thomas Montgomery Residence
Cross Street/directions to job site:
I Tax map/parcel no.: 1703233300203
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Installation of Fujitsu mini split heat pump system
I
I Name: Brian Roqers
I Phone: 541-554-9331
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Fax: 541-988-3182
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cce lie. no.: 171706
Business Name: SUNSET HEATING & AIR INC
Contact:
Address: 5729 MAIN ST BOX 248
City/State/ZIP: SPRINGFIELD, OR 97478
Phone: 5419883181
Fax: 5419883182
Email: erogers1976@aol.com
Metro lie. no.:
City lie, no.:
Upon review and approval by your local jurisdiction, your permit will bo o.mailed or faxod
withi~ one business day. with instructions on how 10 achedule your inspection.
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NOTE: This Authorization To Begin Work expires within 180 days if a permit is not obtained,
The local building department may determine thai an Authorization To BegIn Woril is null and
void if it does not meet applicable land use lilws and local ordinances,
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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 SPRINGFIELD'
Building/Combination Permit
PERMIT NO: COM2009-01759
ISSUED: 12/1012009
APPLIED: 12/10/2009
EXPIRES: 06/10/2010
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fux
541,726-3769 Inspection Line
SITE ADDRESS: 2750 VILLA WAY
ASSESSOR'S PARCEL NO,: 1703233300203
Springfield TYPE OF WORK: Mechunicul Only
TYPE OF USE: New
Residentiul
PROJECT DESCRIPTION: Mini-split heut pump
Owner: MONTGOMERY THOMAS R & S K
Address: 2750 VILLA WAY
SPRINGFIELD OR 97477
I CONTRACTOR INFORMATION I
Contractor Type
Mechanic~ll
Contractor
SUNSET HEATING & AIR INC
License
171706
Expiration Date
08/18/20 I 0
Phone
541-988-3181
BUILDING INFORMATION I
# of Units:
I)rimary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondury Construction Type:
# of Bedrooms:
# of Stories:
Height of Structure
Type of Heut:
Wuter Type:
Runge Type:
Energy Puth:
Sprinkled Building:
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Busement:
Sq Ft Guruge/Curport
Sq Ft Other:
Occupunt Loud:
n/u
DEVELOPMENT INFORMATION I
REQUIRED PARKING
Frontyurd Setbuck:
Side I Setbuck:
Side 2 Set buck:
Reuryard Setback:
Sola I' Setbacks:
"----- ~
Overluy Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
Total:
Hundieapped:
Compact:
Street I mproveWl'tE'Nr
~. rON: Oregon fa
Storm Sewer AliI[~~\tbl't:les adopted b w requires you fo
speciallnstr\~i1lilieation Center Th y the Oregon Utility
n OAR 952-001-0010 those rules are sei forth
Notes: 0090. You may obtai rough OAR 952-001_
_ calling the Center ~r,7~~~',e,~ Of the rules bv
.......'uC"/ lur tne 0 ' ,"~ ,,--,..-''',.........~
C reooll i !tjl'.'i}'li\!-'~'f' ,.~ I
enter is l-i;oo-:';32::2~ . ~'iil\ftiiiOn Descriotion
I PUBLIC IMPROVEMIj;~r~tE:
THIS PERI\r~ifl<5tMlltrMP1RE IF THE WORK
JnRIZc.", 11~ln~R THIS PERMIT IS NOT
:\IJTh., , 'UownspotitslDraip,s: NED FOR
'>: !iI'~ENCEO OR IS ABANuU
- C'. ',\1 PF'iIOD.
DescriJltion
Type of Construction
$ Pel' Sq Ft
. or multiplier
Squal'e Footage
or Bid Amount
Value
nate Calculated
Paee 1 01'2
Status
Issued
CITY OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO: COM2009-01759
ISSUED: 12/10/2009
APPLIED: 12/10/2009
EXPIRES: 06/10/2010
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Total Value of Project
Fe~~ P~id I
Fce Description
+ 12% State Surcharge
+ 5% Technology Fee
1st Appliance
Amount Paid
Date Paid
Receipt Number
$9.48
$3.95
$79.00
12/1 0/09
12/10/09
12/10/09
3200900000000000799
3200900000000000799
3200900000000000799
Total Amonnt Paid
$92.43
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.
Reouired Insnections .
. ,
Ruugh Mechanical: Prior to Cover
Final Mcclwnical: 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 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 proper tim'e, that each address is readable frum 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.
O\\-'ner or Contractors Signature
Date
Pa2e 2 01'2
225 Fifth Street
spriD'gfield; Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2009-0 1759
COM2009-0 1759
COM2009-01759
Payments:
Type of Payment
ONLINE CHGS
cRcceintl
RECEIPT #:
Description
151 Appliance
+ 5% Technology Fee
+ 12% State Surcharge
Paid By
ONLINE PERMIT CHGS
3200900000000000799
City of Springfield Official Receipt
Development Services Department
Public Works Department
Date: 12/10/2009
Item Totul:
Check Number Authorization
Received By Batch Number Number' How Received
NJM
Page I of I
ONLINE SUNSET Online
HTG & AIR
. Payment Total:
JO:22:14AM
Amount Due
79,00
3,95
9.48
$92.43
Amount Paid
$92.43
$92.43
12/1 0/2009