HomeMy WebLinkAboutPermit Mechanical 2010-3-17
City Of Springfield
225 Fifth St
Springfield, OR 97477
Phone: 541-726-3753
Emai1: permitcenter@ci.springfield.or.us
C-IO-3~
Residential Mechanical Authorization To Begin Work
69600-BMC-10-00053
Approval Code: 023163 3/17/2010 8:41 am
..;--,
E-mailedTo:diane@fourseasonsheatair.com
o New Construction
'::TYf:>E~OF 'lV0RK" ': c.:
[K] Addition/alteration/replacement
;'~":"""'-':;.., ". . -~EESCHEDULE
"
001 or 2 family dwelling
o Multi-family 0 Commercial
)
o Accessory
Description
.",.1 Heail.~gIG.ooIJng\,4pplicmce5
Heal Pump
N1inim'Uni,Fees".,"
First Appliance Fee
Mechiuii~!I~ PerrriWF~l!f.
Subtotal
Stale surcharge (12% of permit
total
Technology fee (5% of permillotal)
Total
,- ' CATEGORY OF CPNSTRU<:;'TION
,+
,.
,'.:~JOB SITE'INFORMATION AND LOCATION"
Job Address: 6322 D ST
.",,-
CitylState/ZIP: SPRINGFIELD, OR 97478
$96.00
$11.52
Suitefbldg./apt.no. :
Project Name: VanCleave
$4.80
Cross Streetfdireetions to job site:
TOTAL PERMIT FEE
$112.32
Tax mapfparcel no.:
1702342400100
~'~:yt.+v:
D~SCRIP:fION~OFW9RK .~
i.f,,~k._..,;
Heat pump, air handler
. SITE C0t:J:fACT
Name: Robann VanCleave
Phone: 541-525-5300
Fax:
Email:
CONTRACTOR.;:
CCB lie. no.: 97152
Business Name: FOUR SEASONS HEATING & AIR CONDITIONING INC
Contact:
Address: 1005 INDUSTRIAL PARKWAY
City/State/ZIP: NEWBERG, OR 97132
Phone: 5035381950
Fax: 5035380165
Emall:
Metro lie. no.:
. City lie. no.:
~ \"'0
PJ.\~
~
Upon review and approval by your local jurisdiction, your permit will be e-mailed or faxed
within one business day, with in5truclions on how 10 schedule your in5pection. : J\\)
NOTE, Th;, Aolho,;,";O" To B.g;" Wo,k "p;'" w;lh;" 180 d,y' ;1. p"mll;, "01 O?I~",d : -:. l 6J~\,Il ,
::~ i~~~~lo:su~::n~ee~e::;I::~I~ l:~~ u::t~::~naendt~::ala;rd~:~;;:~a!ion To ~og,~{,WOrM :jS~ null and ~ ~ ~
- '~~t 'O'b~
(}033 d
//h-)
/L-.
UU/YlVD/O
3-/7-10
Inspections Phone: 541.726.3769
This Authorization To Begin Work must be posted at the job site until replaced by a Permit
,
\
225 Fifth Street, Springlield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
~
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: eOM2010-00332
ISSUED: 03/17/2010
APPLIED: 03/17/2010
EXPIRES: 09/17/2010
VALUE:
Status
Iss u ed
SITE ADDRESS: 6322 D.ST
ASSESSOR'S PARCEL NO.: 1702342400100
Springlield TYPE OF WORK: Heating System
TYPE OF USE: New
Residential
PROJECT DESCRIPTION: Heat pump & air handler
Owner: V ANCLEA VE BRIAN S & R J
Address: 702 ELIZABETH CRT
DAYTON OR 97114
I CONTRACTOR INFORMATION I
Contractor Type
Mechanical
Contractor License
FOUR SEASONS HEATING & AIR 97152
BUILDING INFORMATION I
Expiration Date Phone
503-538-1950
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
#,of Stories:
Height o(Structure
,Type of Heat:
Waler 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:
n/a
I DEVELOPMENT INFORMATION I
REQUIRED PARKING
Front yard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd: .
% of Lot Coverage:
Total:
Handicapped:
Compact:
I PUBLIC IMPROVEMENTS I
ATTENTION: Sl~~lMIJMulrea you 'lil
follow rules adopted by il\'e Oregon UtIIItV .
Storm Sewer Available: Notification ,Celi\<!lr:n~4fj)tei1l!Ire set forGo
Special Instruction: In OAR 952-001-0010 through OAR 952.001-
NOTICE: 0090. You may obtain copies of the rules bi1
Notes: TH~S}ER..MIT SHAll EXPIRE IF TH ,/,," .',,":, n~~~2rlfo~:~~~~~~i::~~:=
COMf\ - . ~~ V t' PERMff 15'1~01 " .. I en er 18
AN\i 1 ~HJCED OR IS ABAi\JDONlf~rlll..atlon DescnptlOn ,
, ,00 OA'i' PERI'.:' J.
$ Per Sq Ft Square Footage
or multiplier or Bid Amount
Street Improve~ents:
Description
Type of Construction
Value
Date Calculated
Paee I of2
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2010-00332
ISSUED: 03/17/2010
APPLIED: 03/17/2010
EXPIRES: 09/17/2010
VALUE:
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
,. ~,;,
'I.; ,
h. :', '" ,
,~otal V~lne of Project
· Fees Paid"
Amount Paid Date Paid Receipt Number
$11.52 3/17/10 3201000000000000091
$4,80 3/17/10 3201000000000000091
$79,00 3/17/10 3201000000000000091
$17,00 3/17/10 3201000000000000091
Fee Description
+ 12% State Surcharge
+ 5% Technology Fee
1st Appliance
Heat Pump
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.. ,.
LReaJired InsDections ~
Rough Mechanical: Prior to Cover
Final Mechanical: When all mechanical work is complete.
By signatnre, I state and agree, that 1 have carefully examined the completed application and do hereby certify tbat all
information hereon is true and correct, and 1 fnrther 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 withont permission ofthe 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 inspections 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 rcmain on the site at all
times during construction.
Owner or Contractors Signature
Date
,.,;.~ ., \,
....,'.. l t;,.
.,-.-. -_...'-
#;~f1i,: I. ;~
Page 2 01'2
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
G,P.R~QF;~~.
Wi:. .
City of Springfield Official Receipt
Development Services Department
Public Works Department
RECEIPT #: 3201000000000000091 Date: 03/17/2010 9:07:17AM
Job/Journal Number Description ~. , ,.1.>11 Amount Due
"",'. "
COM20 I 0-00332 I sl Appliance 79.00
COM2010-00332 Heat Pump 17.00
COM20 I 0-00332 + 12% State Surcharge 11.52
COM20 I 0-00332 + 5% Technology Fee 4.80
Item Total: $112.32
Payments: Check Number Authorization
Type of Payment Paid By Received By Batch Number Number How Received Amount Paid
ONLINE CHGS ONLINE PERMIT CHGS NJM ONLINE FOUR Online $112.32
SEASONS
HTG
Payment Total: $112.32
. ,
""..".'<"
c.. '
.i!
cRcccintl
Page I of I
3/17/20 I 0