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Home My WebLink AboutPermit Mechanical 2010-1-11 Mechanical Permit Application 1;')}J)~i>,~RTM~~f'Y~(Q~~j,';::f; I Permit no.: aiD - t.; 0 I Date: U / ) It / ( 0 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'I;;;:[;"')f,~":i~cAJ1~<36R*,,9F,~('bQNsTRUC-T-lqN"\";i:iiI'::;:"" I 0 Residential I 0 Go"ernment .J 0 Commercial I 1~1\\*{;1;jj)~I3~$,imE':IN"9R~A[jQNf;ANi:ll(ttG'C::~t.iQNI!;;tr;t.';~;~i,il I Job site address: Sco r0,5gtb '2>m.e.t- I I City: Sf>(':~J+--"e...\J, I State: O{\ I ZIP: Q7<17;S I I Reference: I Taxlo!.: I I DESCRIPTibNc:>F WQRK '1 6r.'''''ji\AQ (o.vv0.r-j~',^- (qase.~ -tb I +,h'\: f(,,~ _ . 1~~~~~~}!~~:r~:'~.:B~~gBfi~~Qw.~'.~.R~~~l~l!;Wr~~~r~l~~ I Name: SkrkV\ (J\JL. ~~t/:;- I Address: SO 0 N. S"'B''''= S~ City: S; ~>(""-4-ke.1J.. I State: Or- I ZIP: '17471 Phone: L -54V '191.(,(,11 I Fax: ' E-mail: /IVL"Zk 3..q<j € c..o.~CA"i>t: ^et This installation is being made on property owned by me or a member of my immediate family, and is exempt rrom licensing requirements under ORS 701.010. . Sign~ture ?T-J-<jl ^ VV\, ~ . Ili~\~~:i;~!q-oNm~AQj1QR1~iril:~'ljAQi.fAf;19N~i/:t\'iK\Cir~:!;.r"bl I Busin~ss name: I I Address: I. I City: I State: I ZIP: I I Phone: I Fax: I I E-mail: I I CCB license no.: I I Print name: f I Signature: I 225 Fifth Street. Springfield, OR 97477 . PH(541)726-3753 . FAX(541)726-3689 ~,\b \; ~~ ~~ 440-2545-J (II/08/COM) . ..... 'FEE SCHEDULE- . ."1 ;(N);i'liii!0~~~~~;ii i)i\1~~tll".1 I First Appliance I $79.00 $ I !F~rnace/burner including ducts and vents I I Up to lOOk BTU/hr. I $17.00 I $ lOver] OOk BTU/hr. . $20.00 $ I I Heaters/stoves/vents I I Unit heater $17.00 $ I' I Wood/pellet/gas stove/flue $38.00 $ I Repair/alter/add to heating appliance/ I refrigeration unit or cooling system! $58.00 $ absorption system I Evaporated cooler $13.00 $ I I Vent fan with one duct/appliance vent $9.00 I $ I I Hood with exhaust and duct $13.00 I $ I Floor furnace including vent $58.00 I $ I I Gas piping lOne to four outlets I Additional outlets (each) I I Air-handling units, including ducts I Up to 10,000 CFM I I' $11.00 I $ lOver 10,000 CFM $20.00 $ I Compressor/absorption system/heat pump I Up to 3 hp/lOOk BTU $17.00 I $ I Up to 15 hp/500k BTU $29.00 $ I Up to 30 hp/l ,000 BTU $43.00 $ I Up to 50 hpll, 750 Biu $57.00 $ lOver 50 hpll ,750 BTU $95.00 I $ Incinerators ' I Domestic incinerator J . $20.00 I $ 1;\G'omrHe(elaJ~~7rt~';j~"~f':if~:~~r~_\~;ff~;:~~j~~~7,';;;~~~~~~;~'i{;~!:,~-~;;~:)YP~~H.?;~:-~~r/tl I Ente: total.V~luation. of mechanical sys.tem and installatIOn costs $ _ . I ,Enter fee based on valuation of mechanical system, etc. $ r~~J~:~:~n~~:~2'M:~J;1~~,~~~w~~f~~;~~~~Jli~rJ~1'~~~~~~;~tt;1 ,'<~:.~%t~~~~~t I Reinspection $58.00 $ I Specially requested inspections (per hr.) $58,,00 $ I Regulated equipment (uncJassed) I $13.00 $ I Each additional iospectioo: (I) I $58.00 $ 1'1Il"'.."%l:ll'''''''',.".''''''''''''..,........'''.......,._...'"c.._._...W!~_"""",,,,--,,,,_ :k;,~g~nfi:t\tlj~~4~~~~~,~_RJ~lG_A-"f(~U.S,E~A~~;~~a?gRis~;'~~lt~ I (A) Enter subtotal of above fees (or enter set n <t ~ minimum fee of $ 79.00) $ { I (B) investigative fee (equal to [A]) $ I (C) Enter 12%'surcharge (.12 x [MB]) $ I (D)Seismicfee, 1%(.01 x [A]) $ I I (E) Technology Fee (5% offAl) $ ."5 "~J I TOTAL fees and surcharges (A through E): $ q 7 -( 1 $7.00 I $ $4.00 I $ 0"14 Plumbing Permit Application 1.....')i~DEPi\RTMENT.'lrsitoNLy!;~\~~1 Permit no.: r1/i) - liD I Date: ()/,III/07 I 225 Fifth St'eet . Springfield. OR 97477 . PH(541)726-3753 . FAX(541)726-3689 This permit is issued under OAR 918-780-0060, Permits are issued only to the person or contractor doing the work. Permits expire if work is not started within 180 days of issuance or if work is suspended for 180 days. 1'~i:~~~;~\'~:P::V:~V~;~i,~~ERNM6~~PPR0Vbl5~;:'!';)i!~;;triin! I Sanitation approval verified? 0 Yes 0 No I 1 ~ CATEGORVOF CONSTRUCTION . ,.1 I ~Residential I 0 Government I 0 Commercial I ;];'i~Gj0B;sitE .'INFORMAtloN;!./XN O,1I?OCA'I'ION{1,rj'1";.1 I Job site address: 000 N,S'i>1"'=- I I City: Si)'(,""-Mcl I State: 0",- I ZIP: ('0471') I , - I Reference: ~ I Taxlo!.: I 1.'(i....c;~:;;.:."~1~;cY"OESCRlp;rldlli...0I7JWV.ORK<.,J.il~%:~';iJ":l(.J.ijcti;';;1 I w..~ ~~b~'-4,1 I ~~ -- I I . . . PRO'PE R' TV' 'OWN' 'ER'.'.;,.".-._.J,",',;".":.",.,.:,,C'.'0~.;,.,.,:.'.'<'.'1 . - ",,' ,2; , - -', ,', '_~'i~~~f\i.,\;;',~~~ I Name: ~ke~ \fV\, ~\t I I Address: '::'00 l\J. 57"th. <;+ _ I I City: -Sg(\~W.l I State; Ot- I ZIP: Q,-47t I I Phone; -yl(- -' 1-4? -% ~91 Fax; I I E-mail: VVlO--ok.34...1@.Co...- c"'-?+ yj I This installation is being made on residential or farm property owned by me or a member of my immediate family, and is exempt from licensing requirements under OAR 918-695-0020. Signature; I. CONTRACTOR.. INSTALLATION.. . I Business name: Address: City; I Phone: I E-mail: , CCB license no.: I Plumbing license no.: I State: I Fax: I ZIP: . , BCD license no.: Print name: I Signature: . ~\P. Y ~ tf\o/' ~~ 440-2500-J (Il/OS/COM) 1.:?t;:j;lG:~;Wc;l~?;t%~fi~EEE;~CH EDO LEi!;; li:1R~~~,~ttei~~.~"t:{?i~~1~~,~;f~1~;iii~~;;~~j~~i~:~{:~ifg~~~'f;~i,~)~f~i;~i}f~{;~;~.Z~~Ji"~. I New residential 1 bathroomll kitchen (includes:first 100 feet of water/sewer lines, hose bibs, ice maker, under floor Jaw-point drains and rain-drain packages) I 2 bathrooms/1 kitchen $374.00 1 $ I 3 bathr06ms/1 kitchen $439.00 1 $ 1 Each additional bathroom (over 3) $95.00 1 $ I Each additional kitchen (over I) $95.001 $ I Residential fire sprinklers (includes plan review) I 0 to 2,000 square feet $58.00 12,001 to 3,600 squarefeet $116.00 I 3,601 to 7,200 square feet $174.00 I 7,201 square feet and greater $232.00 I Manufactured dwelling or pre-fab (circle one) I Connections to building sewer and I I $58 00 I $ water supply . I Commercial, industrial, and dwellings other than one- or two-family . 1 Minimum fee 1 I $58.00 I $ 1 Each fixture 1 L $19.00 $ 1"1 I Miscellaneousfees 1100' storm, sewer, water line I $76.00 I $ ! Each fixture, appurtenance, and piping $19.00 $ j I Storm water retention/detention facility $19.00 I $ I 1 Irrigation systems $19.00 1 $ I '1 Piping or private storm drainage $19.00 I $ I systems exceedin2: the first] OO.feet I I Specialty fixtures $19.00 I $ I I 1 Reinspection (no. ofhrs. x fee per hr.) $58.00 $ 1 I Special requestedinspections.(no. of $58.00 I $ I I hrs. x fee per hr.) I Each additional inspection: (I) $58.00 I $ I. I ~'iWi~lc~l~g~i~pfpW(gtt~~~~~:&?:-i;+~.~~~~!tt;l Minimum fee I $ I I I Enter value of installation and equipment $ _' I I Enter fee based on installation and equipment value. I $ I I 1~~~~~~~j~;i~:~rc\6;iiljj'ij?.(s)~~~i~1 I (A) Enter subtotal of above fees d J~ I (Minimum Permit Fee $58.00) $ ') 1 (B) Investigative fee (equal to [AD $ I 1 (C)EnterI2%surcharge(.12x[A+BD $ /;J 't" 1 I (D) Technology Fee (5% of[AD $ 7. eu:: I 1 TOTAL fees and surcharges (A through D): I $ (/7 ~ I $238.00 $ $ $ $ $ I I I I 1 I I 1 I I TYPE OF USE: Alteration Relocate laundry room n law requires you to ATTENTION: Or~?^O~ "" \hp. Oregon Utility foilOW rUl~~ ~J"r' Th 'se rules are b~' ,vd-. Notification Center. ~ ugh OAR 952-001- in OAR 952_001-0010 t r~pies of the rules by 0090. you may obtam ~ote: the telephone calling the center. ( Utility Notification . the Oregon -number tor . < 800-332-2344), Center IS ,- .. . Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 500 58TH ST ASSESSOR'S PARCEL NO.: 1702331405600. PROJECT DESCRIPTION: Owner: Address: TRUST DATED 7/12/07 500 58TH ST SPRINGFIELD OR 97478 Owner: Address: STEPHEN BARRETT 500 58TH ST SPRINGFIELD OR 97478 Contractor Type Contractor # of Units: Primary Occupancy Group: Secoudary Occupancy Group: Primary Construction Type Secondary Constrnction Type: # of Bedrooms: - R-3 VB Front yard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: Notes: CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2010-00040 ISSUED: . 01111/2010 APPLIED: 01/11/2010 EXPIRES: 07/11/2010 VALUE: Springfield :rYPE OF WORK: Single Family Residence Reside'ntial .to I CONTRACTOR INFORMATION I .'~'~'.~,:"- License Expiration Date, Phone BUILDING INFORMATION' NI/J;rf&S't~,;ies: . . E If THE WQ)fS(ze: TI~~ghrilJ\Sihr.'tII.I,.L EXP1R PERMIT lS''Nffllst Floor: Aifype-ofl!;!m:UNDER THIS ~ Ft 2nd Floor: ~~lt:*FTiiD OR IS ABANDONED fUSq Ft Basement: C~~n~'R^){~~{ PERIOD. Sq Ft Garage/Carport AEnergytphtli: Sq Ft Other: Sprinkled Building: No Occupant Load: I DEVELOPMENT INFORMATION I REQUIRED PARKING Total: Handicapped: Compact: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: I pUBLIC IMPROVEMENTS I Sidewalk Type: Downspouts/Drains: Paee I 00 Status Issued CITY OF SPRINGFIELD. Building/Combination Permit PERMIT NO: COM2010-00040 ISSUED: 01/11/2010 APPLIED: 01/11/2010 EXPIRES: 07/11/2010 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line I V ~Iuation Oescriotion I Description Tvoe of Constrnction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Total Value of Project Fpp<, PQ;'" · " ,.. Fee Description + 12% State Surcharge + 5oio Techuology Fee 1st Appliauce Fixture Miuimum! Adjustment Plumbing Amount Paid Date Paid Receipt Number $16,44 1/11/10 2201000000000000024 $6.85 1/11/10 2201000000000000024 $79.00 ' 1/11/10 2201000000000000024 $19.00 1/11/10 2201000000000000024 $39.00 1/11/10 2201000000000000024 Total Amount Paid $160.29 I Plan Reviews , To Request an inspection calLthe 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. , UeolJirerlJn~nection~ , Rougb Plumbing: Prior to cover and including required testing. Final Plumbing: Wbeu all plumbing work is complete. Rough Mechanical: Prior to Cover , , Final Mechanical: When all mechanical work is complete, Rough Electric: Prior to Cover Final Electric: When all electrical work is complete, Paee 2 of 3 Status Issued CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2010-00040 ISSUED: 01/11I2010 APPLIED: 01/11/2010 EXPIRES: 07/11I2010 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line By signature, I state and. agree, that I have c~refully examined the completed application and do hereby certify that all information hereou is true and correct, and I fnrther certify that any and all work performed sball 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 witb ORS 701,005 will be used on this project I further agree to ensure that all required inspections are requested at tbe proper time, that each address is readable from tbe street, that the permit card is located at the front of the property, and tbe approved set of plans will remain on the site at all times during constructi?n. . ~~M, ~ 00,/(0 Owner or Contractors Signature Date Page 3 of 3 225 Fifth'Street Spvingfield, Oregon 97477 541-726-3759 Phone Job/Journal Nu,!,ber COM20 I 0-00040 COM20 I 0-00040 COM20 I 0-00040 COM20 I 0-00040 COM20 I 0-00040 Payments: Type of Payment CreditCard cReceintl City of Springfield Official Receipt , Development Services Department Public Works Department RECEIPT #: 2201000000000000024 Date: 01/11/2010 Description Fixture Minimum/Adjustment Plumbing 1st Appliance + 12% State Surcharge + 5% Technology Fee Paid By STEPHEN BARRET Item Total: Check Number Authorization Received By Batch Number Number How Received cjc 041955 In Person Payment Total: t,r; .'! I.. .;') Page I of I 2:04:50PM Amount Due 19,00 39.00 . 79.00 16.44 6.85 $160.29 Amount Paid $160.29 $160.29 1/11/2010