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Home My WebLink AboutPermit Mechanical 2009-12-24 Mechanical Permit Application . " . CITV OFSP'RINGFIELD, OREGON 225 Fifth Street. Springfield, OR 97477 . PH(541)726-3753 . FAX(541)?26~3689 ~~ I ' DEPARTMENT .USE ONLY I Permit no.: (}1 ~ .t$3>? I Date: ~ z..-7--1"---e-1 This permit is issued uuder OAR 918-440'0050. Permits expire if work is not started within 180 days of issuance or if work is suspended for 180 days. r . CATEGORY OF CONSTRUCTION 1111 Residential 1 D Government 1 D Commercial I JOB SITE INFORMATION AND LOCATION I Job site address: I -:) f q 7:J Sf . 1 City: SlJn",,,f,l.-fj, j State: 012-- 1 ZIP: Q1'-l1i 1 SultAiJlJk, f'7CJ -:?'b ~\kl Lot no.c:J\\cC:Q I . --.U DESCRIPTION OF WORK I 1 T"sfA(t M..w wO/)J/..<;!nv.e- 1 I - PROPERTY OWNER 1 Name: J?oVlafJ &~<1<>ro-. I Address: / 3 ,q b:;pf', I I City: SL>nn'1.f..e-() 1 State: D'<... I Phone:5'if T!i.-o<(-7'i I Fax: 1 E.mail: y"pn.fre..lSr@j.IIf?CC1>V\ This installation is being made on property owned by me or a member of my immediate family, and is exempt from licensing ,requiremen~rORS ZW)l}O. /J Signature: /\dY2#-f/ /~~ I CONTRACTORINSTALLA1;(ON dl I Business name: IJ/€0iZ".;f II. /1 C::>" 5tn...c:h "'.., 1 . Address: '3C/.J2l.f 4rtSfow ~OIlO.I 1 I City: f2k".5a..-f 4,'(( I State: oR.- I ZIP: q'1'fsS- I I Phone:.5'f1-9/'1- 3~Sb 1 Fax: 1 I E.mail: I I CCBlicenseno.: /t?(qy{" I I Print name: Siz;,.. Dav;.5 I I Signature: ~ . /' I ~~\9 -<~~f.&"7 ft~ ~"~~ \~ ~ ~.~O: :v~ ~~l& ,~ :',-2 ~ \..'\)' " '::Y '0 , ~~~ru ^ ~","".~M~ ~~~I~..Q ~ I 1 1 1 ZIP: '71'1771 FEE SCHEDULE Residential I Qty'l ~~~t I First Aooliance I $79.00 lFurnace/burner including ducts and ,vents I Up to lOOk BTU/hr. .1 I lOver lOOk BTU/hr. I Heaters/stoves/vents I Unit healer I I Wood/pellet/gas stove/flue I Repair/alter/add to heating appliance! I refrigeration unit or cooling system! $58.00 $ absorption system I Evaporated cooler I I Vent fan wi~h one duct/appliance vent I I Hood with exhaust and duct I I I Floor tumace including vent I I Gas pipine lOne to four ~utlets I I I Additional outlets (each) 1 Air-handling units, including ducts I Up to 10,000 CFM I I $11.00 I $ lOver 10,000 CFM $20.00 $ Compressor/absorption svstemlheat DumD I Up 10 3 hpllOOk BTU $17.00 I $ I Up to 15 hp/500k BTU $29.00 $ I Up to 30 hp/I,OOO BTU $43.00 I $ I Up to 50 hp/I,750 BTU $57.00 $ lOver 50 hpll,750 BTU $95.00 I $ I Incinerators I Domestic in~inerator I Commercial I Enter total valuation of mechanical system and installation costs $ _ . I Enter fee based on valuation ofmec~an.Jcal system, etc. $ I Miscellaneous fees ' ~tem' ~':.t ~~~~I I Reinspection I $58.00 $ I Specially requested inspections (per hr.) I $58.00 I $ I Rcgulated equipmcnt (unclassed) I $13.00 I $ I Each additionalinspection: (I) I $58,00 I $. I APPLICANT USE I (A) Enter subtotal of above fees (or entcr set minimum fee of $ 79.00l I (B) Investigative fee (equal to [Aj) I (ClEnter 12% surcharge (.12 x [A+B]) I (D) Seismic fee, 1% (.01 x [A]) I (E) Technology Fee (5% of [A]) I TOTAL fees and surcharges (A through E): $17.00 1 $ $20.00 $ $17.00 $38.00 $13.00 $ $9.00 I $ $13.00 I $ $58.00 I $ $7.00 I $ $4.00 $ $20.00 I $ $ $ $ $ $ I $<'I1.2-J'J I Total I cost $ I I I I I I I I I I I I I J I I I $ $ CITY OF SPRINGFIELD Building/C9mbination Permit PERMIT NO: COM2009-01833 ISSUED: 12/24/2009 APPLIED: 12/24/2009 EXPIRES: 06/24/2010 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541- 726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 1319 D ST ASSESSOR'S PARCEL NO.: 1703351409600 , Springfield TYPE OF WORK: Wood Stove Sidewalk Type: , Downspouts/Drains: TYPE OF USE: PROJECT DESCRIPTION: Replace wood stove. Owner: GREGORY RONALD I & LYNN L Address: 1319 D ST SPRINGFIELD OR 97477 I CONTRACTOR INfORMATION' "~'fr~"" .--" , Contractor Type . Contractor License # of Units: Primary OCCUPlll1CY Group: Secondary OccupancY,Group: Primary Construction Type Secondary Construction Type: # of Bed rooms: U ~tNF~ .:ft:;~l~~'~~ ~,te:=O""iirm=eN\88bf ~. '1011maY~~~ete\8phone . 'eamntthe~i\J\II\tY ~ __~~-2a44)' ,Sprinkled Building: n/a I DEVELOPMENT INFORMATION' Fmntyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: 'Ovei'lay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: Street Improvements: ; I PUBLIC IMPROVEMENTS' NOTICE:' .. '1< THIS PERMIT SHALL EXPIRE If THE WOR AUTHORIZED UNDER THIS PERMIT IS NOT COMMENCED OR IS ABANDONED FOR '. ANY 180 DAY PERIOD. Storm Sew... Available: Speciallnstl'Uction: Notes: I Valuation Descritition I Desfription $ PC!' S,(Ft or multiplier , .' l\\,e of Construction Square Footage or Bid Aniount Page 1 of 2 Residential Expiration Date Phone Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft OthC!': Occupant Load: REQUIRED PARKING Total: Handicapped: Compuct: Value Date Calculated , , I.ri\ CITY OF SPRINGFIELD Status Issued Building/Combination Permit PERMIT NO: COM2009-01833 ISSUED: 12/24/2009 APPLIED: 12/24/2009 EXPIRES: 06(24/20]0 VALUE: 225 Fifth Street, Springtield, OR 541-726-3753 Phone 541- 726-3676 Fax 541-726-37691nspection Line Total Value of Project Fees paidJ Fee Description + 12% State Surcharge + S% Technology Fee Minimum/Adjustment Mechanical Wood Stove/Insert Amount Paid Date Paid Receipt Number $9.36 $3.90 $40.00 $38.00 12/24/09 12/24/09 12/24/09 12/24/09 2200900000000~01427 2200900000000001427 2200900000000001427 ,2200900000000001427 Total Amount Paid $91.26 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. R,ef\ui~ed Insneetions I Rough Mechanical: Prior to Covel' 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 inspectio'ns 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 times during construction. Owner or Contractors Signature Date Page 2 01'2 225 Fifth Street Sp'rtngfie!d, Oregon 97477 541" 726-3759 Phone City of Springfield Official Receipt Development Services Department Public Works Department Job/Journal Number COM2009-01833 COM2009-0 1833 COM2009-0 1833 COM2009-0 1833 ; Payments: Type of Payment Check cReceinll RECEIPT #: 220090000000Q001427 Date: 12/24/2009 Description Wood Stove/Insert Minimum/Adjustment Mechanical + 5% Technology Fee- + 12% State' Surcharge Paid By RONALD 1 GREGORY Item Total: Check Number Authorization Received By Batch Number Number How Received 5116 klk In Person Payment Total: ~,j,,', ,.,} ,'1,1"1'.,' ~."1' ,; r",' Page I of I 9: II :03AM Amount Due 38,00 40,00 3,90 936 $91.26 Amount Paid $91.26 $91.26 12/24/2009